Metaproteranol (Alupent)

Question 1

Classification

Answer 1

Bronchodilator, sympathetic agent

Question 2

Mechanism of Action

Answer 2

• Relaxes bronchial smooth muscles through beta-2 adrenergic receptors

Question 3

Indications

Answer 3

• Bronchospam associated with:
  
  • Asthma
  • Emphysema
  • Chronic bronchitis

Question 4

Contraindications

Answer 4

• Hypersensitivity
• Cardiac dysrhythmias
• Significant tachycardia, especially if caused by possible digitalis toxicity

Question 5

Adverse Effects

Answer 5

• Cardiovascular: tachycardia, palpitations, irritable dysrhythmia, hypotension
• Neurological: anxiety, dizziness, headache, tremors
• GI: nausea vomiting

Question 6

Administration

Answer 6

• Adult:
  
  • Inhaler: 2-3 inhalations with 2 minutes between inhalations: Each metered spray contains 0.65 mg.
  • Nebulizer: 10-15 mg diluted to 2-3 mL NSS (0.2-0.3 mL of a 5% solution diluted in a total of 3 mL of NSS), administered over 5-15 minutes.
• Pediatrics: 0.5-1 mg/kg 2-3 mL NSS (0.01-0.02 mL/kg of a 5% solution diluted in a total of 3 mL of NSS), administered over 5-15 minutes.

Question 7

Special Considerations

Answer 7

• Shake MDI well before administering
• Alupent is simliar to Isuprel in molecular structure. Monitor closely for cardiac symptoms, dysrhythmia, and HTN.
• MAO inhibiters and other sympathetic agonists may potentiate hypotensive effects.