Hypertension: P1-selective > nonselectives, which also block bronchodilation and peripheral vasodilation and could exacerbate bron-chospasm in obstructive pulmonary disease and lower extremity claudication in peripheral vascular disease.
Angina: Reduce anginal attacks and decrease post-myocardial infarction mortality. Tachydysrhythmias: Used in theophylline overdose, butadenosine preferred over P-blockers. Tremor: Propanolol over prescribed agitation, stage fright, and panic attacks ("shakes"). Migraine headaches.
Bronchospasm: Nonselectives prevent bron-chodilation and promote bronchospasm in chronic obstructive pulmonary disease (COPD) patients.
High anaphylaxis risk: Nonselectives block cat-echol's ability to reduce mast cell degranulation in patients with atopic allergies. Hypoglycemia: All ß-blockers mask sympathetic response to hypoglycemia and interfere with gluconeogenesis/glycogenolysis. Withdrawal: Rebound increased heart rate and elevated blood pressure on abrupt withdrawal can precipitate MI and CVA.
P-Blockers: Hypotension, depressed mental status, slightly elevated K, ECG — prolonged PR interval and widened QRS. CCBs: Hypotension, preserved mental status, ECG — PR prolonged interval and widened QRS complex.
Digoxin: Nausea and vomiting, hyperkalemia, hypertension, and mental status preserved; ECG — prolonged PR, ST changes, atrial then ventricular dysrhythmias.
Na-channel blockers: Seizures, hypotension, depressed mental status, ECG — widened QRS complex.
Cholinergics: SLUDE, DUMBBELS, ECG — sinus tachycardia or paradoxical bradycardia. a-agonists: a1 = phenylpropanolamine (PPA): Severe hypertension, intracranial hemorrhage (ICH), sinus bradycardia; a2 = clonidine, imid-azolines: cause an opioid toxidrome, with pinpoint miosis and sinus bradycardia.
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If you suffer with asthma, you will no doubt be familiar with the uncomfortable sensations as your bronchial tubes begin to narrow and your muscles around them start to tighten. A sticky mucus known as phlegm begins to produce and increase within your bronchial tubes and you begin to wheeze, cough and struggle to breathe.