Metaproterenol (Alupent, Metaprel)

Category:

• Respiratory

Description:

• Antiasthmatic, bronchodilator

Indications:

• Bronchial asthma

• Reversible bronchospasm

Contraindications:

• Preexisting cardiac dysrhythmias associated with tachycardia

Precautions:

• Pregnancy category C

• Ischemic heart disease, cardiac dysrhythmias, hypertension, CHF

• Hyperthyroidism, seizure disorders, diabetes mellitus, excessive use

Adverse Reactions (Side Effects):

• CNS: anxiety, dizziness, headache, insomnia, nervousness, stimulation, tremors

• CV: cardiac arrest, dysrhythmias, hypertension, palpitations, tachycardia

• GI: bad taste, GI distress, nausea, vomiting

• RESP: cough, dyspnea

• MISC: throat irritation, muscle cramps in extremities, hypokalemia  

Dosage:

Administered orally (tablet, solution, aerosol)

• Adult: 

  • PO 20mg 3-4 times daily

  • MDI 2-3 inhalations every 3-4 hours as needed

  • MEB 5-15 inhalations of undiluted 5% solution or 0.2-0.3ml of 5% solution diluted in 2.5-3ml normal saline every 4-6 hours (can be given more frequently if needed)

• Child:  

  • PO (<2 years) 0.4 mg/kg/dose 3-4 times daily, in infants the dose can be given every 8-12 hours

  • PO (2-6 years) 1-2.6 mg/kg/day divided every 6-8 hours; (6-9 years) 10mg 3-4 times daily

  • NEB 0.01-0.12 ml/kg of 5% solution diluted in 2-3ml normal saline every 4-6 hours (may be given more frequently if needed)