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Propranolol, the prototype of the beta-adrenergic receptor antagonists, is a competitive, nonselective beta-blocker similar to nadolol without intrinsic sympathomimetic activity.
Propranolol appears in the blood after 30 minutes and has a maximum (peak) effect between 60 and 90 minutes when taken by mouth.
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Il est aussi anti-arythmique mais il ne faut pas oublier que, paradoxalement, un anti-aryhtmique peut aussi être arythmogène (causer un autre trouble du rythme).
They are also used to prevent migraine headaches, stage fright, and second heart attacks.
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Administration of protein-rich foods increase the bioavailability of propranolol by about 50% with no change in time to peak concentration, plasma binding, half-life, or the amount of unchanged drug in the urine.
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Co-administration of cholestyramine or colestipol with propranolol resulted in up to 50% decrease in propranolol concentrations.
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Similarly limited clinical experience has shown that intravenous propranolol will slow the ventricular rate in patients with Wolff-Parkinson-White syndrome or with tachycardia associated with thyrotoxicosis.
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It may be advisable to withdraw the drug gradually over a period of several weeks.
Propranolol should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Cigarette smoking also induces hepatic metabolism and has been shown to increase up to 77% the clearance of propranolol, resulting in decreased plasma concentrations.
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In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.
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