프로프라놀롤

동물 종별 용량

투여 경로

금기

• Overt heart failure
• Hypersensitivity to beta-blockers
• Greater than 1st degree heart block
• Sinus bradycardia
• Congestive heart failure (unless secondary to a tachyarrhythmia responsive to beta-blockers)
• Bronchospastic lung disease (e.g., feline asthma)
• Bradyarrhythmias
• Acute or decompensated congestive heart failure
• Concurrent administration with alpha-adrenergic agonists (e.g., adrenaline)

이상반응

• Bradycardia
• Lethargy and depression
• Impaired AV conduction
• Congestive heart failure (CHF) or worsening of heart failure
• Hypotension
• Syncope
• Diarrhea
• Hypoglycemia
• Bronchoconstriction
• AV block
• Myocardial depression
• Heart failure
• Hypoglycaemia
• Bronchospasm
• Diarrhoea
• Peripheral vasoconstriction
• Depression

약물 상호작용

• Antacids · May reduce oral propranolol absorption; separate doses by at least one hour
• Anesthetics, General · Additive myocardial depression may occur
• Anticholinergics · May negate cardiac effects of beta-blockers
• Calcium Channel Blockers · Concurrent use should be done with caution due to additive negative inotropic effects, particularly in patients with cardiomyopathy or CHF
• Cimetidine · May decrease the metabolism of propranolol and increase blood levels · moderate
• Diuretics · May increase risk for hypotension · moderate
• Epinephrine · Unopposed alpha effects of epinephrine may lead to rapid increases in blood pressure and decrease in heart rate
• Fluoxetine · May decrease propranolol metabolism; complete heart block reported in one human
• Insulin and Antidiabetic Drugs · Propranolol may prolong the hypoglycemic effects of insulin therapy
• Lidocaine · Clearance may be impaired by propranolol · major
• Methimazole, Propylthiouracil · Propranolol doses may need to be decreased when initiating therapy
• Phenobarbital · May increase the metabolism of propranolol · moderate

모니터링

• ECG (Electrocardiogram)
• Signs of toxicity (bradycardia, hypotension, lethargy)
• Blood pressure (especially if administering IV)
• Heart rate and rhythm (ECG)
• Blood pressure
• Signs of congestive heart failure (e.g., respiratory rate/effort)
• Blood glucose (especially in diabetic patients receiving insulin)

과용량

**Clinical Signs:** The most predominant expected signs are **hypotension** and **bradycardia**. Other possible effects include CNS depression (ranging from depressed consciousness to seizures), bronchospasm, hypoglycemia, hyperkalemia, respiratory depression, pulmonary edema, AV block, or asystole. **Treatment:** * **Decontamination:** If recent oral ingestion, consider emptying the gut and administering activated charcoal. * **Monitoring:** Monitor ECG, blood glucose, potassium, and blood pressure. * **Cardiovascular Support:** Use IV fluids and pressor agents for hypotension. Treat bradycardia with **atropine**; if atropine fails, cautiously administer **isoproterenol**. A transvenous pacemaker may be necessary. * **Heart Failure:** Treat with digoxin, diuretics, oxygen, and IV aminophylline if necessary. * **Antidotal Therapy:** **Glucagon** (5-10 mg IV; human dose) may increase heart rate and blood pressure, reducing the cardiodepressant effects of propranolol. * **Seizures:** Generally respond to IV diazepam.