Vasopressors and inotropes
Isoproterenol (Isuprel) drip
Isuprel
Dosing
| Start | 2 mcg/min |
|---|---|
| Titrate | To heart rate, every 5–10 minutes |
| Maximum | About 10–20 mcg/min |
| Common bags | 1 mg in 250 mL (4 mcg/mL); 2 mg in 250 mL (8 mcg/mL) |
| Dose units | mcg/min |
Line and administration
- Peripheral or central
Watch for
- Tachyarrhythmias and myocardial ischemia
- Vasodilation can drop blood pressure
- Used for bradycardia, heart block bridging and torsades
Isoproterenol: full drug monographIndications, mechanism, pharmacokinetics, cautions and every dose the app lists.
In the one-pagers
- Rhythm GalleryVentricular rhythms and wide-complex tachycardia: Torsades is polymorphic VT twisting around the baseline on a long QT, typically started by a short–long–short sequence. Risk rises with QTc over 500 ms, female sex, bradycardia, low K⁺ or Mg²⁺, heart failure and QT drugs (class IA and III antiarrhythmics, haloperidol, ondansetron, macrolides, fluoroquinolones, methadone). Sustained polymorphic VT g
- Temporary PacingIndications and the 2018 ACC/AHA/HRS guideline: Drugs: atropine IIa for SND and AV-nodal block, including in acute MI; beta agonists (isoproterenol, dopamine, dobutamine, epinephrine) IIb when ischemia is unlikely; aminophylline IIb in inferior MI, IIa after heart transplant or spinal cord injury; atropine after heart transplant III: Harm.
Practice Rhythm Gallery questions free17 exam-style questions with rationales on the topic where isoproterenol comes up most. No account or download needed.
Other vasopressors and inotropes
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For education and exam preparation only. Follow your institution’s protocols. Study aid: check every dose against your local protocols and medical direction, the bag label and your pump.