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Back to Cardiology Drug index
Propranolol hydrochloride - Inderal, Propranolol Intensol
Pregnancy Category C
Drug classes
Beta-adrenergic blocking agent (nonselective beta-blocker)
Antianginal drug
Antiarrhythmic drug
Antihypertensive drug
Mechanism of action
Competitively blocks beta-adrenergic receptors in the heart and juxtoglomerular
apparatus. They lead to decreased heart rate decreasing the work load
by the heart. They do not produce coronary vasodilatation but lead to
a shift and redistribution of coronary circulation to the ischemic areas.
It decreases the release of renin from the kidney, thus lowering blood
pressure.
Indications
Hypertension alone or with other drugs,
especially diuretics
Angina pectoris caused by coronary
atherosclerosis
IHSS to manage associated stress-induced
angina, palpitations, and syncope
Cardiac arrhythmias, especially supraventricular
tachycardia, and ventricular tachycardias induced by digitalis or catecholamines
Myocardial infarction, prevention
of reinfarction in clinically stable patients 1-4 wk after MI
Pheochromocytoma, an adjunctive therapy
after treatment with an alpha-adrenergic blocker to manage tachycardia
before or during surgery or if the pheochromocytoma is inoperable.
Prophylaxis for migraine headache
Management of acute situational stress reaction (stage fright)
Treatment of essential tremor, familial or hereditary
Unlabeled uses: recurrent GI bleeding in cirrhotic patients, schizophrenia,
tardive dyskinesia, acute panic symptoms, vaginal contraceptive
Contraindications
Contraindicated in the presence of allergy to beta-blocking agents, sinus
bradycardia, second- or third-degree heart block, cardiogenic shock, CHF,
bronchial asthma, bronchospasm, COPD, pregnancy (neonatal bradycardia,
hypoglycemia, and apnea have occurred in human infants whose mothers received
propranolol, and low birth weight occurs with chronic maternal use during
pregnancy), lactation.
Use caution in the presence of hypoglycemia and diabetes, thyrotoxicosis,
hepatic dysfunction.
Adverse effects
CNS: Dizziness, vertigo, tinnitus,
fatigue, emotional depression, paresthesias, sleep disturbances, hallucinations,
disorientation, memory loss, slurred speech
GI: Gastric pain, flatulence,
constipation,
diarrhea, nausea, vomiting, anorexia, ischemic colitis, renal
and mesenteric arterial thrombosis, retroperitoneal fibrosis, hepatomegaly,
acute pancreatitis
CV: Bradycardia, CHF, cardiac arrhythmias,
sinoartial or AV nodal block, peripheral vascular insufficiency, claudication,
CVA, pulmonary edema, hypotension
Respiratory: Bronchospasm, dyspnea,
cough, bronchial
obstruction, nasal stuffiness, rhinitis, pharyngitis
GU: Impotence, decreased libido, Peyronie's
disease, dysuria, nocturia, frequency
MS: Joint pain, arthralgia, muscle
cramp
EENT: Eye irritation, dry eyes, conjunctivitis,
blurred vision
Dermatologic: Rash, pruritus, sweating,
dry skin
Allergic
reactions: Pharyngitis, erythematous rash, fever, sore throat,
laryngospasm, respiratory distress
Other: Decreased exercise tolerance,
development of ANAs, hyperglycemia or hypoglycemia, elevated serum transaminase,
alkaline phosphatase, and LDH
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