Observations on the efficacy of propranolol for the prophylaxis of migraine. Ann Neurol. Wideroe TE, Vigander T. Propranolol in the treatment of migraine.
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Prys-Roberts C. Phaeochromocytoma — Recent progress in its management. Br J Anaesth. Adrenergic blockade with phenoxybenzamine and propranolol in a cohort of 60 patients undergoing surgery for phaeochromocytoma. While once first-line treatment for hypertension , the role for beta-blockers was downgraded in June in the United Kingdom to fourth-line as they perform less well than other drugs, particularly in the elderly, and evidence is increasing that the most frequently used beta-blockers at usual doses carry an unacceptable risk of provoking type 2 diabetes.
Propranolol is also used to lower portal vein pressure in portal hypertension and prevent oesophageal variceal bleeding. Propranolol is often used by musicians and other performers to prevent stage fright. Propranolol is currently being investigated as a potential treatment for post-traumatic stress disorder.
Propranolol should be used with caution in patients with: [1]. Propranolol is contraindicated in patients with: [1]. Adverse drug reactions ADRs associated with propranolol therapy are similar to other lipophilic beta blockers see beta blocker.
Beta-blocking agents in general reduce perfusion of the placenta which may lead to adverse outcomes for the neonate, including pulmonary or cardiac complications, or premature birth. The newborn may experience additional adverse effects such as hypoglycemia and bradycardia. Most beta-blocking agents appear in the milk of lactating women. This is especially the case for a lipophilic drug like propranolol.
Breastfeeding is not recommended in patients receiving propranolol therapy. Beta blockers, including propranolol, have an additive effect with other drugs which decrease blood pressure, or which decrease cardiac contractility or conductivity.
Clinically-significant interactions particularly occur with: [1]. The usual maintenance dose ranges for oral propranolol therapy vary by indication:.
Intravenous IV propranolol may be used in acute arrhythmia or thyrotoxic crisis. Propranolol along with a number of other membrane-acting drugs have been investigated for possible effects on P. In vitro positive effects until recently had not been matched by useful in vivo anti-parasite activity against P. Based on the concept of a functional adrenergic receptor that could mediate the effects of catecholamines, the introduction of the first beta-blocker caused a revolution in human pharmacotherapy that has continued to impact favorably on the health of millions of patients worldwide with a wide variety of CV and non-CVDs.
Their introduction also opened the door to fundamental discoveries of basic receptor structure and function, which have influenced the development of other drug classes for various medical conditions. Healio News Cardiology Vascular Medicine. Issue: December By William H. Read next. December 01, Receive an email when new articles are posted on. Please provide your email address to receive an email when new articles are posted on.
You've successfully added to your alerts. You will receive an email when new content is published. The interprofessional healthcare team includes the patient, the physician, the nurse, certified nurse's aid, and the pharmacist, all working in concert to optimize the patient's health.
Therefore, all team members must remain up to date with literature on medication and potential side effects. Furthermore, they must utilize excellent communication skills between the different disciplines to ensure the desired outcome for their patient.
A proper history and continuous physical assessments will need to be performed by the health care team to ensure that propranolol is used correctly, with appropriate precautions maintained in at-risk populations to minimize adverse outcomes. Nurses can offer counsel to the patients on their dosing regimen. The pharmacist can check for potential interactions, reinforce the nurse's counsel, answer patient questions, and report any concerns to the prescriber.
This interprofessional approach will yield better therapeutic outcomes when using propranolol. Current drug metabolism. Annals of Indian Academy of Neurology. American journal of cardiovascular drugs : drugs, devices, and other interventions.
Pediatric dermatology. Journal of psychopharmacology Oxford, England. Rehsia NS,Dhalla NS, Mechanisms of the beneficial effects of beta-adrenoceptor antagonists in congestive heart failure. Experimental and clinical cardiology. Frontiers in pharmacology. The Annals of pharmacotherapy. Scientific reports. Pozzi R, [True and presumed contraindications of beta blockers. Peripheral vascular disease, diabetes mellitus, chronic bronchopneumopathy].
Italian heart journal. Supplement : official journal of the Italian Federation of Cardiology.
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