Presentation
A frequent conference presenter and speaker who is widely cited in the national media, he is past president of the Section on Clinical Child Psychology (the former Division 12) of the American Psychological Association, and of the International Society [books.google.com]
We present here the first case report of successful treatment of lithium-induced tremor with nadolol, which was selected because the patient had compromised liver function. The patient's liver function tests remained stable with the therapy. [ncbi.nlm.nih.gov]
Entire Body System
- Congestive Heart Failure
The rationale for this pilot study was based on the paradigm shift that was observed with the use of beta-blockers in congestive heart failure, which once contraindicated because of their acute detrimental effects, have now been shown to reduce mortality [ncbi.nlm.nih.gov]
Sympathetic stimulation may be a vital component supporting circulatory function in patients with congestive heart failure Inhibition by beta-blockade may precipitate more severe failure; although beta-blockers should be avoided in overt congestive heart [reference.medscape.com]
Tell your doctor if you have asthma, chronic obstructive pulmonary disease, congestive heart failure, heart block, low heart rate, low blood pressure, impaired kidney function, diabetes mellitus, overactive thyroid, or peripheral vascular disease. [clevelandclinic.org]
Nonallergenic bronchospasm, cerebrovascular insufficiency, well-compensated congestive heart failure (CHF), diabetes mellitus, hyperthyroidism/thyrotoxicosis, liver disease, renal impairment, peripheral vascular disease. [rxlist.com]
Respiratoric
- Rales
Assess patient routinely for evidence of fluid overload (peripheral edema, dyspnea, rales/crackles, fatigue, weight gain, jugular venous distention). Hypertension: Check frequency of refills to determine compliance. [nursing.unboundmedicine.com]
Cardiovascular
- Hypotension
Nadolol may reduce reflex orthostatic hypotension. [pdr.net]
Additive hypotension may occur with other antihypertensives, acute ingestion of alcohol, or nitrates. [nursing.unboundmedicine.com]
Drug: nsaid s may decrease hypotensive effects; may mask symptoms of a hypoglycemic reaction to insulin, sulfonylureas ; prazosin, terazosin may increase severe hypotensive response to first dose. Absorption: 30–40% of PO dose absorbed. Peak: 2–4 h. [robholland.com]
Amphetamines, ephedrine, epinephrine, norepinephrine, phenylephrine, pseudoephedrine: severe vasoconstriction and bradycardia Antihypertensives, nitrates: additive hypotension Clonidine: increased hypotension and bradycardia Digoxin: additive bradycardia [medical-dictionary.thefreedictionary.com]
- Slow Pulse
Advise patient to notify health care professional if slow pulse, difficulty breathing, wheezing, cold hands and feet, dizziness, confusion, depression, rash, fever, sore throat, unusual bleeding, or bruising occurs. [nursing.unboundmedicine.com]
- Diastolic Hypertension
Abstract Nadolol was effective and well tolerated as once-daily monotherapy for mild to moderate essential supine diastolic hypertension (SDBP) in 10 young (mean age, 39 years) and 12 elderly (mean age, 68 years) patients in a single-blind, placebo-baseline [ncbi.nlm.nih.gov]
- Jugular Venous Distention
Assess patient routinely for evidence of fluid overload (peripheral edema, dyspnea, rales/crackles, fatigue, weight gain, jugular venous distention). Hypertension: Check frequency of refills to determine compliance. [nursing.unboundmedicine.com]
Musculoskeletal
- Painful Muscle Cramps
muscle cramps Neuro: paresthesia Misc: drug-induced lupus syndrome * CAPITALS indicate life-threatening. [nursing.unboundmedicine.com]
Skin
- Angioedema
ADVERSE REACTIONS Severe heart failure / Delayed / 1.0-1.0 visual impairment / Early / 0-1.0 agranulocytosis / Delayed / 0-1.0 thrombotic thrombocytopenic purpura (TTP) / Delayed / 0-1.0 laryngospasm / Rapid / 0-1.0 angioedema / Rapid / 0-1.0 exfoliative [pdr.net]
- Hyperpigmentation
/ 0.1-0.6 vomiting / Early / 0.1-0.6 nausea / Early / 0.1-0.6 nasal congestion / Early / 0.1-0.6 tinnitus / Delayed / 0.1-0.6 syncope / Early / Incidence not known insomnia / Early / Incidence not known nightmares / Early / Incidence not known skin hyperpigmentation [pdr.net]
Urogenital
- Anuria
Agents MeSH PA D018373 Peripheral Nervous System Agents MeSH PA D013565 Sympatholytics Drug Use (View source of the data) scroll--> Disease Relation SNOMED_ID DOID Hypertensive disorder indication 38341003 DOID:10763 Angina pectoris indication 194828000 Anuria [drugcentral.org]
- Oliguria
[…] nephropathy contraindication 58574008 Hypercalcemia contraindication 66931009 DOID:12678 Hyperparathyroidism contraindication 66999008 DOID:13543 Hepatic coma contraindication 72836002 DOID:12550 Diabetes mellitus contraindication 73211009 DOID:9351 Oliguria [drugcentral.org]
Neurologic
- Dysarthria
Other clinical signs of toxicity include: anorexia; visual impairment; drowsiness; muscular weakness; fasciculations or myoclonia; ataxia; dysarthria or slurred speech; stupor or coma; confusion or impaired cognition; seizures; and arrhythmias. [pdr.net]
Workup
As with any use of β-blocker therapy in a pediatric patient, a cardiac workup is advised before the start of nadolol therapy; blood pressure and heart rate monitoring should be performed at one and two hours after the first dose and continued during dose [ncbi.nlm.nih.gov]
Before the start of treatment with any β-blocker, it is mandatory to carry out a cardiac workup and to monitor the patient’s BP and HR one and two hours after the initial dose and throughout the course of dose escalation. [ajhp.org]
Rhythm
- Sinus Arrest
Because beta-blockers have similar effects, concomitant administration of beta-blockers with amiodarone may cause additive electrophysiologic effects (slow sinus rate or worsen AV block), resulting in symptomatic bradycardia, sinus arrest, and atrioventricular [pdr.net]
Blocks
- Third Degree Atrioventricular Block
Before using this medication, tell your doctor or pharmacist your medical history, especially of: certain types of heart rhythm problems (such as a slow heartbeat, second- or third-degree atrioventricular block) blood circulation problems (such as Raynaud's [myhealth.alberta.ca]
Treatment
Combination treatment attenuated this response and significantly reduced plasma aldosterone. Neither treatment had any effect on plasma noradrenaline levels. [ncbi.nlm.nih.gov]
It is also used in the prophylactic treatment of migraine, and as an adjunct in the treatment of hyperthyroidism. 2011-01-10 Nadolol is administered as an equimolar mixture of the four possible 2,3- cis -diastereoisomers of 5-[3-(tert-butylamino)-2-hydroxypropoxy [ebi.ac.uk]
Prognosis
A hemodynamic response to treatment is associated with a better long-term prognosis. [ncbi.nlm.nih.gov]
Etiology
Stable cirrhotic patients of mixed etiology underwent an intravenous glucose tolerance test and hyperinsulinemic-euglycemic clamp for the measurement of insulin secretion and insulin sensitivity (n = 16) and a 75-g oral glucose tolerance test (n = 17) [ncbi.nlm.nih.gov]
Epidemiology
Part 2, short-term reductions in blood pressure: an overview of randomized drug trials in their epidemiological context. Lancet. 1990; 335:827-38. http://www.ncbi.nlm.nih.gov/pubmed/1969567?dopt=AbstractPlus 107. Alderman MH. [drugs.com]
GLOSSARY AAN = American Academy of Neurology ; AE = adverse event ; CI = confidence interval ; ER = extended-release ; MAM = menstrually associated migraine ; PMP = perimenstrual period ; RCT = randomized controlled trial Epidemiologic studies suggest [doi.org]
Cancer Epidemiology. 38 (3): 279–85. doi:10.1016/j.canep.2014.03.011. PMID 24786858. ^ Kim HY, Jung YJ, Lee SH, Jung HJ, Pak K (2017). "Is Beta-Blocker Use Beneficial in Breast Cancer? A Meta-Analysis". [en.wikipedia.org]
Pathophysiology
The recent demonstration that beta blockers selectively blunt the increased morning risk of myocardial infarction suggests that these agents block the pathophysiologic consequences of stressors concentrated in the morning. [ncbi.nlm.nih.gov]
Prevention
BACKGROUND/AIMS: beta-blockers effectively prevent first variceal bleeding (FVB) in cirrhotic patients. In patients with ascites, however, their use might be precluded by a high rate of contraindications and side effects. [ncbi.nlm.nih.gov]
I’ve used Nadolol (Corgard) for migraine prevention for about 15 years, ramped up to 20 mg initially but only been taking 10 mg for the past 8 years. [migraine.com]
Although the mechanism by which Apo-Nadolol tablets 40mg help prevent migraine is not fully known, it is thought to involve prevention of vasoconstriction (blood vessel narrowing) of the internal carotid artery, by blocking beta receptors in the brain [inhousepharmacy.vu]