Propranolol

Details About Generic Salt ::  Propranolol 

Main Medicine Class:: Cardiovascular System   Sub Medicine Class ::  Anti Hypertensives

4D. ANTI-HYPERTENSIVES in 4. CARDIOVASCULAR SYSTEM
PROPRANOLOL
NON-SELECTIVE ß-BLOCKER | ANTI-ANGINAL, ANTI-ARRHYTHMIC, ANTI-HYPERTENSIVE, ANTI-MIGRAINE
also comes under 1H. Anti-Migraine & Anti- Vertigo Drugs in 1. Nervous System,   4A. Drugs for Cardiac Failure & Shock in 4. Cardiovascular System,   4B. Anti-Arrhythmics in 4. Cardiovascular System,   4C. Anti-Anginals in 4. Cardiovascular System,   8A. Thyroid & Anti-Thyroid Drugs in 8. Endocrine/Steroid Hormones & Metabolic System

Indications & Dose: ANGINA PO Adult 40mg BID/TID may be increased usual range 120-240mg/day max 320mg/day | ANXIETY PO Adult 40mg/day increased to 40mg BID/TID | CARDIAC ARRHYTHMIAS Long-term therapy PO Adult 30-160mg/day in divided doses | Emergency therapy IV Adult 1mg/1min slowly, may be repeat if necessary for q2min, max total of 10mg in conscious patients & 5mg for anesthesia patients | HYPERTENSION PO Adult Initially 40–80mg BID, usual range 160–320mg/day max 640mg/day Child Neonates: 250µg/kg TID max 2mg/kg TID, 1 month-12 yr: 0.25-1mg/kg TID max 5mg/kg/day in divided doses, >12 yr: Same as adult dose Elderly Initiate with low dose | HYPERTHYROIDISM PO Adult 10-40mg TID/QID Child Neonates: 250-500µg/kg TID, 1 month-18 yr: 250-500µg/kg TID/QID adjusted according to response max 1mg/kg QID or total dose of 160mg/day | IV Adult 1mg/1min slowly, may be repeat if necessary for q2min, max total of 10mg in conscious patients & 5mg for anesthesia patients | HYPERTROPHIC CARDIOMYOPATHY PO Adult 10-40mg TID/QID | MIGRAINE Prophylactic therapy PO Adult Initially 40mg BID/TID, dose increased at weekly intervals up to 160mg/day max 240mg/day Child <12 yr: 10-20mg BID/TID >12yr: Same as adult dose | MYOCARDIAL INFARCTION PO Adult 40mg QID 2-3 days, followed by 80mg BID & should be given within 5-21 days of MI | PHEOCHROMOCYTOMA PO Adult 60mg/day 3 days before surgery with a-blocker. If tumor is inoperable administer 30mg/day (prolong therapy) Child Neonates: 250-500µg/kg TID, 1 month-18 yr: 250-500µg/kg TID/QID adjusted according to response max 1mg/kg QID or total dose of 160mg/day | PORTAL HYPERTENSION PO Adult 40mg BID, dose may be increased up to 160mg BID

Contra: hypersensitivity, Uncompensated CHF, cardiogenic shock, severe sinus bradycardia, severe hyperactive airway diseases

Precautions: history of severe anaphylaxis to allergens, abrupt withdrawal, myasthenia gravis, peripheral vascular disease, DM, psychiatric disease, thyrotoxicosis, pheochromocytoma, HF, renal/hepatic impairment

ADR: Serious: arterial insufficiency, increased AV conduction disturbances, bradycardia, cardiogenic shock, CHF, hypotension, impaired myocardial contractility, Raynaud’s syndrome, syncope, SJS, anaphylaxis, hyper/hypoglycemia, pulmonary edema, TEN, visual disturbances, polyarthritis, Others: alopecia, anorexia, diarrhea, respiratory distress, nausea, cramping, erythema multiforme, urticaria, exfoliative dermatitis, amnesia, cognitive dysfunction, confusion, depression, dizziness, hallucinations, insomnia

DDI: Serious Digoxin causes excessive bradycardia, NSAIDs causes HTN, Theophylline clearance is reduced, Thioridazine/Chlorpromazine decreases BP, Antacids decreases drug absorption, Adrenaline hypertensive effect is increased, Neuromuscular blockers leads to bradycardia & hypotension, Antidiabetics results in severe hypoglycemia

Diet: Tab: Empty stomach; Cap: With/without food,

Monitor: ECG, HR, BP

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