Dangerous Drug: Propranolol Hydrochloride



Dangerous Drug: Propranolol Hydrochloride





(proe pran’ oh lol)

Apo-Propranolol (CAN), Inderal, Inderal LA, InnoPran XL

PREGNANCY CATEGORY C


Drug Classes

Antianginal

Antiarrhythmic

Antihypertensive

Beta-adrenergic blocker (nonselective)


Therapeutic Actions

Competitively blocks beta-adrenergic receptors in the heart and juxtoglomerular apparatus, decreasing the influence of the sympathetic nervous system on these tissues, the excitability of the heart, cardiac workload and oxygen consumption, and the release of renin and lowering BP; has membrane-stabilizing
(local anesthetic) effects that contribute to its antiarrhythmic action; acts in the CNS to reduce sympathetic outflow and vasoconstrictor tone. The mechanism by which it prevents migraine headaches is unknown.


Indications



  • Hypertension alone or with other drugs, especially diuretics


  • Angina pectoris caused by coronary atherosclerosis (not ER products)


  • Idiopathic hypertrophic subaortic stenosis to manage associated stress-induced angina, palpitations, and syncope


  • Atrial fibrillation; to control rapid ventricular rate (not ER products)


  • To reduce CV mortality in clinically stable patients 5–21 days after MI (not ER products)


  • Pheochromocytoma, an adjunctive therapy after treatment with an alpha-adrenergic blocker to manage tachycardia before or during surgery or if the pheochromocytoma is inoperable (not ER products)


  • Prophylaxis for migraine headache


  • Treatment of essential tremor, familial or hereditary (not ER products)


  • Unlabeled uses: Migraine prevention in children and adolescents; smoking cessation; traumatic brain injury



Available Forms

ER capsules—60, 80, 120, 160 mg; tablets—10, 20, 40, 60, 80 mg; injection—1 mg/mL; oral solution—4, 8 mg/mL


Dosages

Adults

Oral



  • Hypertension: 40 mg regular propranolol bid PO or 80 mg PO SR or ER daily initially; usual maintenance dose, 120–240 mg/day PO given bid or tid or 120–160 mg PO SR or ER daily (maximum dose, 640 mg/day).


  • Angina: 80–320 mg/day PO divided bid, tid, or qid or 80 mg PO SR or ER daily initially; gradually increase SR or ER dosage at 3- to 7-day intervals; usual maintenance dose, 160 mg/day PO (maximum dose, 320 mg/day).


  • IHSS: 20–40 mg PO tid or qid or 80–160 mg PO SR or ER daily.


  • Arrhythmias: 10–30 mg PO tid or qid.


  • Post-MI: 120 mg/day PO divided tid. After 1 mo, may titrate to 180–240 mg/day tid or qid (maximum dose, 240 mg/day).


  • Pheochromocytoma: Preoperatively, 60 mg/day PO for 3 days in divided doses; inoperable tumor, 30 mg/day in divided doses.


  • Migraine: 80 mg/day PO daily (SR or ER) or in divided doses; usual maintenance dose, 160–240 mg/day.


  • Essential tremor: 40 mg PO bid; usual maintenance dose, 120 mg/day (maximum dose, 320 mg/day).

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Jul 21, 2016 | Posted by in NURSING | Comments Off on Dangerous Drug: Propranolol Hydrochloride

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