Related Subjects: |Hypertension |Acute Heart Failure |Chronic Heart Failure
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- This was the first commercially available beta blocker
Action
- Propranolol is a non-selective beta-blocker as it blocks the action of epinephrine and norepinephrine on both alpha1 and alpha2-adrenergic receptors
- Propranolol is a highly lipophilic drug achieving high concentrations in the brain
Indication/Oral Dose
- Hypertension: Propanolol 80 mg bd (160-320 mg per day)
- Angina: Propanolol 40 mg tds increasing to 320 mg/day
- Arrhythmias: Propanolol 40 mgs bd or tds
- Anxiety: Propanolol 10-40 mgs tds
- Portal hypertension : Propanolol 40 mg bd
- Post MI : Propanolol 40 mgs tds to 80 mg bd
- Migraine prevention Propanolol 40 mg bd - 80 mg bd
Contraindications
- Bradycardia <60bpm, systolic BP <100mmHg
- Asthma/Bronchospasm, 2nd or 3rd-degree heart block
- Avoid in Diabetes especially with thiazide
- Uncontrolled/Decompensated/Acute heart failure/severe heart failure
- Severe hypotension, Phaeochromocytoma except with an alpha-blocker
- Sick sinus syndrome, Significant peripheral vascular disease
- Concomitant use of verapamil
Side effects
- Headache, Fatigue, Cold peripheries
- Worsening diabetic control and may mask hypoglycaemia
- Insomnia, Nightmares, Worsening Raynaud's
- Heart failure, Bradycardia