ISOETHARINE HYDROCHLORIDE
| ISOETHARINE HYDROCHLORIDE (eye-soe-eth'a-reen) Beta-2 Classifications: beta-adrenergic agonist; bronchodilator; Therapeutic: bronchodilator; beta-adrenergic agonist Prototype: Albuterol Pregnancy Category: C |
Availability
1% solution
Action
Synthetic sympathomimetic stimulant with relatively rapid onset and long duration of action. Has selective affinity for beta2-adrenoreceptors on bronchial and selected arteriolar musculature. Relieves reversible bronchospasm and by bronchodilation facilitates expectoration of pulmonary secretions. Increases vital capacity and decreases airway resistance.
Therapeutic Effect
Effective in relieving brochospasms as well as facilitating expectoration of respiratory secretions.
Uses
Bronchial asthma and reversible bronchospasm occurring with bronchitis and emphysema.
Contraindications
Known hypersensitivity to sympathomimetic amines and to bisulfites; concomitant use with epinephrine or other sympathomimetic amines; patients with preexisting cardiac arrhythmias associated with tachycardia; pregnancy (category C).
Cautious Use
Older adults; hypertension; acute coronary artery disease; CHF; cardiac diseases; asthma; hyperthyroidism, diabetes mellitus; tuberculosis; history of seizures.
Route & Dosage
| Bronchospasm Adult: Inhalation 0.5–1 mL 0.5% or 0.5 mL 1% solution diluted 1:3 with normal saline or 2–4 mL 0.125% solution undiluted or 2–5 mL 0.2% solution undiluted or 2 mL 0.25% solution undiluted per nebulizer q4h (max: 5 times/d); 1–2 inhalations from an MDI q4h up to 5 times/d Child: Inhalation 0.01 mL/kg of 1% solution (max: 0.5 mL) diluted in 2–3 mL normal saline |
Administration
Inhalation- Give on arising in morning and before meals to reduce fatigue from activity by improving lung ventilation.
- Wait 1 full min after initial 1 or 2 inhalations (Bronkometer) to be sure of necessity for another dose. Action should begin immediately and peak within 5–15 min.
- Alternate therapy with concurrent epinephrine administration but do not administer simultaneously because of danger of excessively rapid heartbeat.
- Do not use discolored or precipitated solutions.
- Protect solutions from light, freezing, and heat.
Adverse Effects (≥1%)
CV: Tachycardia, palpitations, changes in BP, cardiac arrest. GI: Nausea, vomiting. CNS: Headache, anxiety, tension, restlessness, insomnia, tremor, weakness, dizziness, excitement. Respiratory: Cough, bronchial irritation and edema; tachyphylaxis.Interactions
Drug: Epinephrine, other sympathomimetic bronchodilators possibly have additive effects; mao inhibitors, tricyclic antidepressants potentiate action on vascular system; effects of both beta-adrenergic blockers and isoetharine antagonized when given together.Pharmacokinetics
Onset: Immediate. Peak: 5–15 min. Duration: 1–4 h. Metabolism: In lungs, liver, GI tract, and other tissues. Elimination: Excreted by kidneys.Nursing Implications
Assessment & Drug Effects
- Do not use this product if patient has a history of allergy to sulfite agents. The preservative sodium bisulfite is in the hydrochloride formulation.
- Monitor cardiac status and report tachycardia and palpitations. Older adults may be especially sensitive to adrenergic drug effects.
Patient & Family Education
- Close eyes when actuating the nebulizer.
- Use inhalation therapy according to prescribed regimen. Overuse may decrease desired effect and cause symptoms including tachycardia, palpitations, headache, nausea, dizziness.
- Read information and instructions furnished with the aerosol form of isoetharine.
- Increase daily fluid intake to aid in liquefaction of bronchial secretions.
- Discontinue drug and notify physician if a sudden increase in dyspnea occurs.
- Do not discard drug applicator. Refill units are available.
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; 
Canadian drug name; 
Prototype drug