Propranolol hydrochloride

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[proh-PRAN-oh-lohl] Pregnancy Category: C

Apo-Propranolol M, Detensol M, Dom-Propranolol M, Inderal, Inderal 10, 20, 40, 60, 80, and 90, Inderal LA, Novo-Pranol M, Nu-Propranolol M, PMS Propranolol M, Propranolol In-tensol (Rx)

Classification: Beta-adrenergic blocking agent; antiarrhythmic (type II)_

See also Beta-Adrenergic Blocking Agents.

Action/Kinetics: Manifests both beta-1- and beta-2-adrenergic blocking activity. Antiarrhythmic action is due to both beta-adrenergic receptor blockade and a direct membrane-stabilizing action on the cardiac cell. Has no intrinsic sympathomimetic activity and has high lipid solubility. Onset, PO: 30 min; IV: immediate. Maximum effect: 1-1.5 hr. Duration: 3-5 hr. tV2: 2-3 hr (8-11 hr for long-acting). Therapeutic serum level, antiarrhythmic: 0.05-0.1 mcg/mL. Completely metabolized by liver and excreted in urine. Although food increases bioavailabil-ity, absorption may be decreased.

Uses: Hypertension (alone or in combination with other antihyper-tensive agents). Angina pectoris, hypertrophic subaortic stenosis, prophylaxis of MI, pheochromocytoma, prophylaxis of migraine, essential tremor. Cardiac arrhythmias. Anxiety, aggressive behavior. Contraindications: Hypersensitiv-ity to propranolol, cardiogenic shock, 2nd or 3rd degree heart block, sinus bradycardia, congestive heart failure, cardiac failure. Bronchial asthma, bronchospasms including severe COPD. Special Concerns: Children, diabetes mellitus, hepatic disease, hy-perthyroidism, hypotension, lactation, myasthenia gravis, peripheral vascular disease, renal disease. It is dangerous to use propranolol for pheochromocytoma unless an al-pha-adrenergic blocking agent is already in use.

Side Effects: Oral: Dry mouth. CV: AV block, bradycardia, CHF, hypotension, peripheral vascular insufficiency, vasodilation. CNS: Bizarre dreams, depression, disorientation, fatigue, hallucinations, lethargy, paresthe-sias. GI: Acute pancreatitis, colitis, constipation, cramps, diarrhea, hepa-

Btomegaly, nausea, vomiting. Hematologic: Agranulocytosis, thrombocytopenia. Allergic: Fever, sore throat, respiratory distress, rash, pharyngitis, laryngospasm, anaphylaxis. Skin: Fever, pruritus, rash. Ophthalmic: Dry eyes. GU: Decreased libido, impotence, urinary tract infection. Other: Hypoglycemia. Respiratory: Bron-chospasm, dyspnea, wheezing. Additional Side Effects: Psoriasislike eruptions, skin necrosis, SLE (rare).

Drug Interactions: See also Drug Interactions for Beta-Adrenergic Blocking Agents and Antihyperten-sive Agents.

How Supplied: Capsule, extended release: 60 mg, 80 mg, 120 mg, 160 mg; Concentrate: 80 mg/mL; Injection: 1 mg/mL; Solution: 20 mg/5 mL, 40 mg/5 mL; Tablet: 10 mg, 20 mg, 40 mg, 60 mg, 80 mg

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