Propranolol HCL
Trade names: Deralin, Inderal
Class: beta-adrenergic
blacking agent, antiarryhthmic. Pregnancy: (Category C / D if used in 2nd or 3rd
trimesters) Action:
manifests both beta1 and beta 2
adrenergic blocking activity.
Uses:
ý Angina
pectoris.
ý Hypertension.
ý Cardiac arrhythmias.
ý Prophylaxis of migrin. ý Prophylaxis
of MI.
ý Pheochromocytoma Dose:
ý by mouth, hypertension, initially 80 mg twice daily, increased
at weekly intervals as required; maintenance 160–320 mg daily
ý Angina, initially 40 mg 2–3 times daily; maintenance 120–240 mg
daily
ý Arrhythmias, hypertrophic obstructive cardiomyopathy, anxiety
tachycardia, and thyrotoxicosis (adjunct), 10–40 mg 3–4 times daily
ý Anxiety with symptoms such as palpitations, sweating, tremor, 40
mg once daily, increased to 40 mg 3 times daily if necessary
ý Prophylaxis after myocardial infarction, 40 mg 4 times daily for
2–3 days, then
80 mg twice daily, beginning 5 to 21 days after infarction
ý Migraine prophylaxis and essential tremor, initially 40 mg 2–3
times daily; maintenance 80–160 mg daily
ý By intravenous injection, arrhythmias and thyrotoxic crisis, 1
mg over 1 minute; if necessary repeat at 2-minute intervals; max. 10 mg (5 mg
in anesthesia) Contraindications:
Bradycardia, C.H.F., cardiogenic shock,
diabetes, thyrotoxicosis, chronic bronchitis, asthma, bronchospasm, emphysema.
Side effects:
Bradycardia, C.H.F., hypotension, cold
extremities (due to peripheral vasoconstriction), edema, dyspnia, shortness of
breath, nausea, vomiting, hepatomegaly and bronchospasm.
Nursing
considerations:
v Instruct patient/family to take blood pressure and pulse.
v Provide written instructions as when to call physician (e.g. HR
below 50 beat/min).
v Consult the physician before interrupting the therapy.
v Some drugs lead to blurring of vision, so that tell patients not
to engage in activities need mental alertness.
v Instruct
patient to dress warmly during cold weather.
v Diabetic patient should be very careful about symptoms of
hypoglycemia. v Report any asthma-like symptoms.
