Propranolol: instructions for using the medicine, structure, Contraindications

When ATH: C07AA05

Propranolol: characteristic

Propranolol hydrochloride is a white crystalline powder. Soluble in water and alcohol.

Propranolol: pharmachologic effect

Gipotenzivnoe, antianginalnoe, antiarrhythmic, uterotoniziruyuschee.

Propranolol: application

Arterial hypertension, angina, sinus tachycardia (incl. hyperthyroidism), supraventricular tachycardia, tachysystolic atrial fibrillation, supraventricular and ventricular premature beats, gipertroficheskaya cardiomyopathy, myocardial infarction, mitral valve prolapse, subaortalnыy stenosis, sympatykoadrenalovыy management of patients with the syndrome dyэntsefalnыm, cardiopsychoneurosis, portal hypertension, essential tremor, panic attacks, violent behavior, migraine (prevention), Auxiliary treatment of pheochromocytoma (Only in combination with alpha-blockers), thyrotoxicosis (incl. preoperative preparation), thyrotoxic crisis, The primary weakness of labor, menopausal vasomotor symptoms, abstinence symptom; treatment of akathisia, neuroleptic-induced.

Propranolol: Contraindications

Hypersensitivity, AV block II-III degrees, sinoatrialynaya blockade, bradycardia (less 55 u. / min), sick sinus syndrome, hypotension, acute and severe chronic heart failure, Prinzmetal angina, cardiogenic shock, obliterating vascular disease, bronchial asthma.

Propranolol: restrictions on use

Chronic bronchitis, эmfizema, diabetes, gipoglikemiâ, Acidosis, the liver and kidneys, psoriasis, spasticheskiy colitis, myasthenia, pregnancy, lactation, advanced age.

Propranolol: use during pregnancy and lactation

Maybe, if the effect of therapy outweighs the potential risk to the fetus. At the time of treatment should stop breastfeeding.

Propranolol: side effects

Cardio-vascular system and blood (hematopoiesis, hemostasis): bradycardia, heart failure, OF блокада, gipotenziya, the peripheral blood circulation, trombotsitopenicheskaya purpura, leukopenia, agranulocytosis.

From the nervous system and sensory organs: asthenia, dizziness, headache, insomnia, drowsiness, nightmares, reduction in the rate of mental and motor responses, emotional lability, depression, excitation, hallucinations, disorientation in time and space, kratkovremennaya amnesia, violation of the sensitivity, paresthesia; dry eyes, visual disturbances, keratokonъyunktyvyt.

From the digestive tract: nausea, vomiting, abdominal pain, diarrhea or constipation, mezenteryalnoy artery thrombosis, ishemicheskiy colitis.

From the respiratory system: pharyngitis, chest pain, cough, breathlessness, ʙronxo- and laryngospasm, respiratory distress syndrome.

For the skin: alopecia, rash, itching, exacerbation of psoriasis.

Other: withdrawal, the weakening of the libido, impotence, Peyronie's disease, arthralgia, allergic reactions, lupus syndrome, gipoglikemiâ, fever.

Propranolol: interaction

Strengthens (mutually) negative effect of verapamil and diltiazem on the myocardium, It prolongs the effect of non-depolarizing muscle relaxants, inhibits the excretion of lidocaine. Weaken hypotensive effect of NSAIDs, glucocorticoids, Estrogens, cocaine; reinforce-nitrates and other antihypertensive. Heparin, antacids lowers plasma levels; Cimetidine and fenotiazina-increase. Avoid simultaneous intake with MAO inhibitors. Theophylline metabolism slows down and increases its concentration in blood plasma.

Propranolol: overdose

Symptoms: dizziness, bradycardia, arrhythmia, heart failure, gipotenziya, collapse, difficulty breathing, acrocyanosis, convulsions.

Treatment: gastric lavage and appointment of absorbent, simptomaticheskaya therapy: atropyn, beta-agonists (Isoprenaline, izadrin), sedativnыe (diazepam, Lorazepam), cardiac (doʙutamin, Dopamine, epinephrine) vasopressor drugs means, glucagon and the like.; may conduct transvenous pacing. Hemodialysis nyeeffyektivyen.

Propranolol: Dosing and Administration

B /, spray, slowly, adult for the relief of arrhythmia, tireotoksicheskogo crisis, acute ischemia - 1 mg for 1 m, if necessary, repeated at intervals of 2 m (under the control of ECG and blood pressure). The maximum dose - 10 mg. Inside, drinking a liquid or semi-liquid food (water, juice, yablochnoe puree, pudding), adult: with hypertension -initial dose is on 80 mg 2 once a day, supporting dose-160-320 mg. Prolonged form: 80 mg 1 once a day, If necessary, up to 120-160 mg once, under the control of blood pressure. When arrhythmias -on 10-30 mg 3-4 times a day, subaortic stenosis at -on 20-40 mg 3-4 times a day. When portal hypertension, angina, migraine, excitation, tremors initial dose of 40 mg 2-3 times a day, supporting — 160, 120–240, 80–160, 80–120, 80-160 mg/day, respectively. When pheochromocytoma -30-60 mg/day for 3 days (before the operation). Myocardial infarction - Since 5 on the 21 St day after the heart attack on 40 mg 4 times a day for 2-3 days, then - 80 mg 2 once a day. For induction of labor - By 20 mg after 30 minutes 4-6 times (80-120 mg/day), for the prevention of postpartum hemorrhage - By 20 mg 3 times a day for 3-5 days. When glaucoma - vnutrykonъyunktyvalno in the affected eye.

Babies: inside, the initial dose: 0,5-1 mg/kg/day, supporting — 2-4 mg/kg/day 2 admission.

Propranolol: precautions

Treatment should be under regular medical supervision. Prolonged use should consider the appointment of additional cardiac glycosides. It reduces the compensatory cardiovascular reactions in response to the use of general anesthetics. In just a few days before the anesthesia should stop taking or choose anesthetic with the least negative inotropic effects. Not recommended in / in a children. Elderly patients are at increased risk of side effects from the CNS. If abnormal liver function is recommended to decrease doses and observation of the first 4 day care. May mask the symptoms of hypoglycemia (taxikardiju) patients with diabetes, insulin, etc.. hypoglycemic agents. Perhaps the increased severity of hypersensitivity reactions and the lack of effect of conventional doses of epinephrine with aggravated allergic history. At the time of treatment remenduetsya the use of alcohol. Be wary of during the drivers of vehicles and people, skills relate to the high concentration of attention. Stop treatment gradually, for about 2 Sun.

Propranolol: Special instructions

During treatment may change the test results in laboratory studies (increase in urea, transaminases, fosfataz, LDH).

Propranolol: interaction