Question

k) what are the most common adverses effects of propanolol (Inderal)?

l) for what other indications, besides the treatment of hypertension, is propranolol (Inderal) prescribed?

Answer 1

Propranolol :

​​​​​​Propranolol is a non selective beta blocker.

Adverse effects of propranolol:

1) Propranolol can accentuate myocardial insufficiency and can precipitate CHF/Edema by blocking sympathetic support to the heart especially during cardiovascular stress.

2) Bradycardia: Resting heart rate may be reduced to 60/min or less.

3) Propranolol worsens chronic obstructive lung disease,can precipitate life threatening bronchial Asthana.

4) Propranolol exacerbate variant angina due to unopposed alpha mediated coronary constriction.

5) Carbohydrates tolerance may be impaired in prediabetics.

6)Plasma lipid profile is altered on long term use.

7) withdrawal of propranolol after the chronic use should be gradual , otherwise rebound hypertension, worsening of angina or even sudden death can occur.

8) Propranolol is contraindicated in partial heart block: arrest may occur.

9) Tiredness and reduced exercise capacity.

10)Cold hands and feet, worsening of peripheral vascular disease due to blockade of vasodilator beta 2 receptor.

11) Others are : GIT upset, lack of drive, nightmare, forgetfulness, rarely hallucinations.

Indications of propranolol :

1) Hypertension

2) Angina pectoris: Taken on regular schedule, decrease the frequency of attacks and increase exercise tolerance.

3) Myocardial infraction.

A) secondary prophylaxis of MI by preventing reinfraction, by preventing sudden ventricular fibrillation at the second attack of MI.

B) Myocardial salvage during evolution of MI:. - may limit the infract size. -may prevent arrhythmias including ventricular fibrillation.

4) Cardiac arrhythmias

5) congestive heart failure.

6) Dissecting aortic aneurysm.

7)Pheochromocytoma.

8) Thyrotoxicosis.

9) migraine.

10) Anxiety.

11) Essential tremors.

12) Glaucoma.

13) Hypertrophic obstructive cardiac myopathy.