Propranolol: Difference between revisions

Latest revision as of 01:19, 7 March 2021

General

Type: Beta blockers, nonselective
Dosage Forms:
- IV: 1mg/mL
- PO conventional: 10, 20, 40, 60, 80mg
- PO extended release: 60, 80, 120, 160mg
Common Trade Names: Inderal

Adult Dosing

Thyroid storm
- 1-2mg IV over 10 min; if tolerates then 1-2mg boluses q15 minutes until HR <100
- May follow with drip @ dose required for HR control (ie 3-5mg/hr)
- Alternate 60-80mg PO q4h
Variceal bleed ppx
- 20mg BID titrated up to max tolerated dose
Migraine ppx
- Starting dose 80mg daily as either XL or divided q6-8hr. Max 160-240mg/day
Essential tremor
- 40mg BID starting dose
HOCM
- 80-160mg daily as either XL or divided q6-8 hr
Akathisia
- 10mg bid-tid starting dose. Max 120mg / day

Pediatric Dosing

Special Populations

Pregnancy Rating: Category C; risk of IUGR, neonatal hypoglycemia/bradycardia/respiratory depression. Still preferred agent for thyrotoxicosis
Lactation: Enters breast milk
Renal Dosing: N/A
Hepatic Dosing: N/A

Contraindications

Allergy to class/drug
Decompensated heart failure, except high output failure secondary to tachyarrhythmia
Bradycardia / high degree heart block

Adverse Reactions

Serious

Rebound symptoms with abrupt withdrawal of treatment
Heart failure
Agranulocytosis, thrombocytopenia
Bronchospasm
SJS/TEN

Common

Bradycardia
Orthostasis

Pharmacology

Half-life: 3-6 hrs, 8-10 hrs extended release
Metabolism: Hepatic
Excretion: Urine
Mechanism of Action: Nonselective β-blocker

References

Lexicomp

Authors:

@@ Line 3: / Line 3: @@
 *Dosage Forms:
 **IV: 1mg/mL
-**PO conventional: 10, 20, 40, 60, 80 mg
+**PO conventional: 10, 20, 40, 60, 80mg
-**PO extended release: 60, 80, 120, 160 mg
+**PO extended release: 60, 80, 120, 160mg
 *Common Trade Names: Inderal
@@ Line 10: / Line 10: @@
 *[[Thyroid storm]]
 **1-2mg IV over 10 min; if tolerates then 1-2mg boluses q15 minutes until HR <100
-**May follow with gtt @ dose required for HR control (ie 3-5 mg/hr)
+**May follow with drip @ dose required for HR control (ie 3-5mg/hr)
-**Alternate 60-80 mg PO q4h
+**Alternate 60-80mg PO q4h
 *Variceal bleed ppx
-**20 mg bid titrated up to max tolerated dose
+**20mg BID titrated up to max tolerated dose
 *[[Migraine]] ppx
-**Starting dose 80 mg daily as either XL or divided q6-8hr. Max 160-240 mg/day
+**Starting dose 80mg daily as either XL or divided q6-8hr. Max 160-240mg/day
 *Essential tremor
-**40 mg bid starting dose
+**40mg BID starting dose
 *[[HOCM]]
-**80-160 mg daily as either XL or divided q6-8 hr
+**80-160mg daily as either XL or divided q6-8 hr
 *Akathisia
-**10 mg bid-tid starting dose. Max 120 mg /day
+**10mg bid-tid starting dose. Max 120mg / day
 ==Pediatric Dosing==
@@ Line 33: / Line 33: @@
 ==Contraindications==
 *Allergy to class/drug
-*Decompensated heart failure, except high output failure 2/2 tachyarrhythmia
+*Decompensated heart failure, except high output failure secondary to tachyarrhythmia
 *Bradycardia / high degree heart block
 ==Adverse Reactions==
 ===Serious===
-*Rebound sx with abrupt withdrawal of tx
+*Rebound symptoms with abrupt withdrawal of treatment
 *Heart failure
 *Agranulocytosis, thrombocytopenia
@@ Line 48: / Line 48: @@
 ==Pharmacology==
-*Half-life:
+*Half-life: 3-6 hrs, 8-10 hrs extended release
-*Metabolism:
+*Metabolism: Hepatic
-*Excretion:
+*Excretion: Urine
-*Mechanism of Action:
+*Mechanism of Action: Nonselective β-blocker
 ==See Also==
+*[[Beta-blockers]]
+*[[Beta-blocker toxicity]]
+*[[Antiarrhythmics]]
+*[[Antihypertensive medications]]
-==Sources==
+==References==
+Lexicomp
 <references/>
-[[Category:Drugs]]
+[[Category:Pharmacology]]
+[[Category:Cardiology]]