|Drug Name:||Propranolol Hydrochloride|
|Manufacturer:||Baxter Healthcare Corporation|
|Other Info:||Alopecia, LE-like reactions, psoriaform rashes, dry eyes, male impotence, and Peyronie’s disease have been reported rarely. Oculomucocutaneous reactions involving the skin, serous membranes and conjunctivae reported for a beta-blocker (practolol) have not been associated with propranolol.|
Intravenous administration is usually reserved for life-threatening arrhythmias or those occurring under anesthesia. Supraventricular arrhythmiasIntravenous propranolol is indicated for the short-term treatment of supraventricular tachycardia, including Wolff-Parkinson-White syndrome and thyrotoxicosis, to decrease ventricular rate.
Use in patients with atrial flutter or atrial fibrillation should be reserved for arrythmias unresponsive to standard therapy or when more prolonged control is required.
Reversion to normal sinus rhythm has occasionally been observed, predominantly in patients with sinus or atrial tachycardia.Ventricular tachycardias With the exception of those induced by catecholamines or digitalis, propranolol is not the drug of first choice.
In critical situations when cardioversion techniques or other drugs are not indicated or are not effective, propranolol may be considered.
If, after consideration of the risks involved, propranolol is used, it should be given intravenously in low dosage and very slowly, as the failing heart requires some sympathetic drive for maintenance of myocardial tone.
Some patients may respond with complete reversion to normal sinus rhythm, but reduction in ventricular rate is more likely.
Ventricular arrhythmias do not respond to propranolol as predictably as do the supraventricular arrhythmias.
Intravenous propranolol is indicated for the treatment of persistent premature ventricular extrasystoles that impair the well-being of the patient and do not respond to conventional measures.Tachyarrhythmias of digitalis intoxicationIntravenous propranolol is indicated to control ventricular rate in life-threatening digitalis-induced arrhythmias.
Severe bradycardia may occur.
(See ).Resistant tachyarrhythmias due to excessive catecholamine action during anesthesia Intravenous propranolol is indicated to abolish tachyarrhythmias due to excessive catecholamine action during anesthesia when other measures fail.
These arrhythmias may arise because of release of endogenous catecholamines or administration of catecholamines.
All general inhalation anesthetics produce some degree of myocardial depression.Therefore, when propranolol is used to treat arrhythmias during anesthesia, it should be used with extreme caution, usually with constant monitoring of the ECG and central venous pressure. (See ).
Sympathetic stimulation may be a vital component supporting circulatory function in patients with congestive heart failure, and its inhibition by beta blockade may precipitate more severe failure. Although beta-blockers should be avoided in overt congestive heart failure, some have been shown to be highly beneficial when used with close follow-up in patients with a history of failure who are well compensated and are receiving additional therapies, including diuretics as needed.Beta-adrenergic blocking agents do not abolish the inotropic action of digitalis on heart muscle.