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