Propranolol

Question 1

What is another name for Propranolol?

Answer 1

Inderal

Question 2

What kind of drug is Propranolol?

Answer 2

Beta-adrenergic blocker
Antidysrhythmic class II

Question 3

How does Propranolol work?

Answer 3

It is a nonselective beta-adrenergic blocker that inhibits chronotropic, inotropic and vasodilator response to beta-adrenergic stimulation. It slows the sinus rate, depresses AV conduction, decreases cardiac output, and reduces blood pressure.
It also decreases Oxygen demand and reduces risk of sudden death in patients with AMI.

Question 4

What is the onset of Propranolol?

Answer 4

Within 1-2 hours

Question 5

What is the duration of Propranolol?

Answer 5

6-12 hours

Question 6

What are indications for Propranolol?

Answer 6

• hypertension
• angina
• VT, Vfib, and rapid supraventricular dysrhythmias
• patients with suspected MI and unstable angina (can reduce incidence of VF)
• useful as adjunctive agent with fibrinolytic therapy
• to convert to NSR or slow ventricular response in supraventricular tachydysrhythmias
• reduce myocardial ischemia in AMI patients with elevated heart rate, BP, or both

Question 7

What are contraindications for Propranolol?

Answer 7

• hemodynamically unstable patients
• STEMI if increased risk of cardiogenic shock is present
• 2nd or 3rd degree blocks, active asthma, reactive airway disease, severe bradycardia or SBP <100mmHg

Question 8

What are some adverse reactions of Propranolol?

Answer 8

• bradycardia
• 2nd or 3rd degree AV block
• asthma
• cardiogenic shock
• pulmonary edema
• uncompensated CHF
• cocaine intoxication

Question 9

What are some drug interactions with Propranolol?

Answer 9

• catecholamine-depleting Drugs may potentiate hypotension
• sympathomimetic effects may be antagonized
• Verapamil may worsen AV AV conduction abnormalities
• Succinylcholine effects may be enhanced
• Isoproterenol, Norepinephrine, Dopamine, and Dobutamine may reverse Propranolol
• Epinephrine may cause rise in BP, decrease in HR, and severe vasoconstriction
• signs of hypoglycemia may be masked

Question 10

How is Propranolol supplied?

Answer 10

1mg/mL vials

Question 11

What is the adult dose of Propranolol?

Answer 11

1-3mg IV over 2-5min (do not exceed 1mg/min)

can be repeated after 2 minutes (to total dose of 0.1mg/kg)

Question 12

What are some special considerations for Propranolol?

Answer 12

• pregnancy safety category C
• use cautiously in elderly patients
• use cautiously in patients with impaired hepatic or renal function
• Atropine should be readily available