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Showing posts with label propranolol. Show all posts
Showing posts with label propranolol. Show all posts
Wednesday, 22 June 2011

Propranolol Indication Doses Contra Indication And Adverse Effects

Indications:
A non-cardio selective betablocker indicated in the treatment of hypertension, angina pectoris, cardiac arrhythmias, anxiety, hyperthyroidism, hypertrophic obstructive cardiomyopathy and prevention of re-infarction after acute myocardial infarctions.
 
Doses & Administrations:
Oral: Adult: Hypertension: The usual dose is 80mg twice daily with maintenance range of 160-320mg daily. Angina Pectoris: 40mg 2-3 times daily. maintenance dose is 120 to 240mg daily. Anxiety: Tremor and migraine, initially 40mg 2-3 times a day, maintenance 160 to 240mg daily. Prophylaxis after infarction, 40mg four times daily for 2 to 3 days then 80mg twice daily, beginning 5-21 days after infarction. Pediatric: Arrhythmias-0.5-1mg/kg/day in a divided doses to a maximum of 60mg/day. Hypertension-0.5-1mg/kg/day up to 2mg/kg daily. Thyrotoxicosis-2mg/kg/day every 6 hours-interval. Parenteral: (Arrythmias) Adult: 1mg over 1 minute, if necessary repeat at 2 minutes interval. Maximum: 10mg (5mg in anesthesia). Pediatric: 0.01-0.1mg/kg/ dose over 3 to 5 minutes up to maximum of 1mg/day.
 
Contra Indications: 
Bronchial asthma, sinus bradycardia, second or third degree heart block, cardiogenic shock.
 
Precautions:
Late pregnancy, impaired renal or hepatic functions, lactation, diabetics, mellitus, myasthenia gravis, cardiac failure.
 
Pregnancy Status:
Category "C"
 
Renal Failure Doses:
Dosage adjustment is not necessary in patients with renal failure.
 
Lactation Status:
Controversial
 
Interactions:
Avoid concomitant use with amiodarone, benzodiazepine, chlorpromazine, anti-diabetics, cimetidine, oral contraceptive, succinyl choline, epinephrine, theophylline and lidocaine. Decrease carbohydrate tolerance and increase in BUN.
 
Adverse Effects: 
Bronchospasm, bradycardia, heart failure, peripheral vasconstrictions, fatigue, sleep disturbance, rash (rare).
 
Nursing Considerations: 
- HISTORY:ALLERGY TO BETA BLOCKRS, SINUS BRADYCARDIA, CARDIOGENIC SHOCK, BRONCHIAL ASTHMA, DIABETES, THYROTOXICOSIS, PREGNANCY. - ENSURE THAT ALPHA ADRENERGIC BLOCKERS HAS BEEN GIVEN BEFORE GI VING PROPANOLOL WHEN TREATING PATIENT WITH PHEOCHROMOCYTOMA, - PROVIDE CONTINUOUS CARDIAC MONITORING AND REGULAR MONITORING OF BP WITH IV FORM. IV DILUTION: 1 mg/ 50 ml 10-15 MIN. 15 mg/ 250ml TITRATE RATE DILUTE IN NS / D5W