Prototype Drug Unit 6- Propanolol

Question 1

Therapeutic classification

Answer 1

Antihypertensive, antidysrhymthic

Question 2

Pharmacologic

Answer 2

Nonselective beta-adrenergic blocker

Question 3

Therapeutic effects and uses

Answer 3

Hypertension, Angina pectoris, dysrhythmias, migraine prophylaxis, prophylaxis of MI

Question 4

Mechanism of action

Answer 4

Affects both beta1 receptors in the heart, and beta2 receptors in the lung and other locations throughout the body. (Reduces heart rate and slows conduction velocity through the AV node)

Question 5

Adverse effects

Answer 5

Hypotension, headache, dizziness, fatigue, anxiety, depression, lethargy, impotence, peripheral vascular insufficiency, hypoglycemia (low blood sugar)

Question 6

Contraindications/precautions

Answer 6

Don’t give it to people with cardiogenic shock, sinus bradycardia, great than first degree heart block, and severe HF. Don’t give to people with COPD or asthma because it can constrict airways. Be careful with people with diabetes because it can lower blood sugar.

Question 7

Black box warning

Answer 7

Abrupt withdrawal is not advised with angina or heart disease. Dosage should be gradually reduced over 1-2 weeks and the drug should be reinstituted if angina symptoms develop during this period.

Question 8

Drug interactions

Answer 8

Additive hypotension and Bradycardia occurs if taken with other beta blockers or calcium channel blockers. Phenothiazines can also cause hypotension effects. Same with MAOIs. Ethanol and antacids decrease absorption, and albuterol will antagonize antihypertensive actions.

Question 9

Herbal/food interactions

Answer 9

Hawthorn drops blood pressure, large doses of vitamin C reduces absorption.

Question 10

Treatment of overdose

Answer 10

Plasma volume expanders or vasopressors to raise blood pressure to normal levels and atropine to counteract bradycardia. Isoproterenol may be used for reversing bronchospasm.