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  Propranolol

Pharmacokinetics | Indications | Routes of Administration and Dosage | Contra Indications | Precautions | Interactions | Brand Names


Systems Cardiovascular and Peripheral Vascular System
Category Non selective B-blocker


Pharmacokinetics

It is a drug that is well absorbed after oral administration,and is extensively metabolised in the liver with a little unchanged drug appearing in the urine. It readily crosses the blood brain barrier. Its bioavailability is 30%, which is higher via parentral administration than via oral administration.



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Indications

Propranolol is used in the treatment of hypertension, to relieve angina and in IHD patients to help prevent additional Myocardial Infarction, to correct cardiac arrhythmias, in hyperthyroidism. It has a membrane stabilising effect in large doses. It causes decreased automaticity, conduction velocity and increases the refractory period to nerve impulses in nerve conduction. As a result, they decrease the heart's need for blood and oxygen by reducing its workload. They also help to maintain the cardiac rhythm.



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Routes of Administration and Dosage

Regular short-acting oral dose: For angina : Adults: 80 to 320 mg a day taken in two, three, or four divided doses. For cardiac arrhyhmias: Adults: 10 to 30 mg three or four times a day. Children: 500 micrograms (0.5 mg) to 4 mg per kilogram of body weight a day taken in divided doses. For hypertension: Adults : 40 mg two times a day. Children: 500 micrograms (0.5 mg) to 4 mg per kilogram of body weight a day taken in divided doses. For cardiomyopathy: Adults : 20 to 40 mg three or four times a day. For treatment after a MI: Adults: 180 to 240 mg a day taken in divided doses. For treating pheochromocytoma: Adults: 30 to 160 mg a day taken in divided doses. For preventing migraine headaches: Adults : 20 mg four times a day. For trembling: Adults: 40 mg two times a day. For long-acting oral dosage form (extended-release capsules): Hypertension: Adults: 80 to 160 mg once a day. Doses up to 640 mg once a day may be needed in some patients. For angina : Adults: 80 to 320 mg once a day. For preventing migraine headaches: Adults: 80 to 240 mg once a day. For injection dosage form: For cardiac arrhythmias: Adults: 1 to 3 mg given at a rate not greater than 1 mg per minute. Dose may be repeated after two minutes and again after four hours if needed. Children : 10 to 100 micrograms (0.01 to 0.1 mg) per kilogram of body weight given intravenously every six to eight hours.



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Contra Indications

Propranolol is contraindicated in Sinus bradycardia, heart blocks, untreated cardiac failure,and cardiogenic shock, severe arterial disorder, hypoglycaemia, severe haemorrhage and asthma.



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Precautions

Precaution should be taken during abrupt reduction in dosage, pregnancy, lactation, elderly, IHD,CCF, renal or hepatic dysfunction.



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Interactions

It may increase the risk of serious allergic reaction to these drugs: Aminophylline, Caffeine, Oxitriphylline, Theophylline: the effects of both these drugs and beta-blockers may be reduced; in addition, theophylline levels in the body may be increased, especially in patients who smoke. Oral antidiabetics or Insulin: There is an increased risk of hyperglycemia ; beta-blockers may cover up certain symptoms of hypoglycemia such as increases in pulse rate and blood pressure, and may make the hypoglycemia last longer. Calcium channel blockers: bepridil, diltiazem, felodipine, flunarizine, isradipine, nicardipine, nifedipine, nimodipine, verapamil, clonidine, guanabenz : Effects on blood pressure may be increased. Adverse effects may occur if clonidine, guanabenz, or a beta-blocker is stopped suddenly after use together. Adverse cardiac effects may occur when beta-blockers are used with calcium channel blockers. Cocaine : Cocaine may block the effects of beta-blockers; in addition, there is an increased risk of Hypertension, tachcardia, and possibly cardiac disorders if cocaine is used while taking a beta-blocker. With Monoamine oxidase (MAO) inhibitors: Taking beta-blockers within 2 weeks of taking monoamine oxidase (MAO) inhibitors may cause severe hypertension.



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Brand Names

B.P Norm (Medley), Betabloc (USV), Betabloc Forte (USV), Betaspan (Smithkline Beecham), Cardiolong (Pace), Ciplar (Cipla), Corbeta (Sarabhai), Propal (Sigma Lab).



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Pharmacokinetics | Indications | Routes of Administration and Dosage | Contra Indications | Precautions | Interactions | Brand Names

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