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Propranolol


Presentation

  • This case report presents a 45-day-old girl who had subglottic hemangioma presenting with wheezing and stridor.[ncbi.nlm.nih.gov]
  • Furthermore, the present study aimed to investigate the exact apoptotic pathway underlying the therapeutic effect of propranolol against IH.[ncbi.nlm.nih.gov]
  • We present a case of Kasabach-Merritt syndrome treatment with orally administered propranolol.[ncbi.nlm.nih.gov]
  • We present the case of a child with infantile haemangiomas of the urinary bladder, as well as internal and cutaneous lesions, treated with propranolol.[ncbi.nlm.nih.gov]
  • A small subset of patients with infantile haemangiomas (IHs) can present with serious complications, the most common of which is ulceration. Ulcerated IHs can be extremely painful and always result in scarring.[ncbi.nlm.nih.gov]
Easy Bruising
  • Tell your doctor right away if any of these rare but very serious side effects occur: easy bruising/bleeding, signs of infection (e.g., fever, persistent sore throat ), aching/ swollen joints . A very serious allergic reaction to this drug is rare.[webmd.com]
  • Additional potentially serious side effects include numbness or tingling of the limbs, unexplained weight gain, increased thirst and/or urination, aching joints, and easy bruising or bleeding.[study.com]
Congestive Heart Failure
  • heart failure, diabetes mellitus, hyperthyroidism/thyrotoxicosis, liver disease, renal impairment, peripheral vascular disease, myasthenic conditions Sudden discontinuance can exacerbate angina and lead to myocardial infarction Use in pheochromocytoma[reference.medscape.com]
  • The most frequently cited side effects of propranolol are bronchospasm, bradycardia, hypotension, and congestive heart failure. 3 Although not usually considered a side effect, hypoglycemia has been reported. 4,5 Copyright 1973 by the American Academy[pediatrics.aappublications.org]
  • Additional information Although propranolol is generally well-tolerated, it should be administered with caution in view of contraindications, which include asthma, congestive heart failure, diabetes mellitus, and atrioventricular block, a type of heart[multiplesclerosisnewstoday.com]
  • WARNINGS Cardiac Failure Sympathetic stimulation may be a vital component supporting circulatory function in patients with congestive heart failure, and its inhibition by beta blockade may precipitate more severe failure.[globalrph.com]
Intravenous Administration
  • Treatment of thyrotoxic storm with intravenous administration of propranolol. Ann Intern Med. 1969 May; 70 (5):985–988. [ PubMed ] [ Google Scholar ] Hadden DR, Bell TK, McDevitt DG, Shanks RG, Montgomery DA, Weaver JA.[ncbi.nlm.nih.gov]
  • INDICATIONS AND USAGE Cardiac Arrhythmias Intravenous administration is usually reserved for life-threatening arrhythmias or those occurring under anesthesia.[globalrph.com]
  • Plasma concentrations and bioavailability of propranolol by oral, rectal and intravenous administration in man. Biopharmaceutics and Drug Disposition, 7: 559-566. [ Links ] 7.[scielo.br]
  • Andreas Broocks, Teresa A Pigott, James L Hill, Stephanie Canter, Tana A Grady, Francine L'Heureux and Dennis L Murphy, Acute intravenous administration of ondansetron and m-CPP, alone and in combination, in patients with obsessive–compulsive disorder[doi.org]
  • Intravenous Administration IV bolus injection: No dilution necessary. Monitor ECG and central venous pressure during IV administration. Adults: Inject IV at a rate not to exceed 1 mg/minute. Children: Infuse slowly IV over 10 minutes.[pdr.net]
Hypotension
  • Propranolol can have potentially serious adverse side effects, including bradycardia, hypotension, and hypoglycemia. There is sparse literature on the use of propranolol for IHs in patients with preexisting hypoglycemic conditions.[ncbi.nlm.nih.gov]
  • We are of the opinion that endogenous catecholamine release during hypotensive and septic episodes in conjunction with β-adrenergic blockage from propranolol could lead to severe splanchnic vasoconstriction from unopposed α-adrenergic activity and hence[ncbi.nlm.nih.gov]
  • Risperidone: (Moderate) Risperidone may induce orthostatic hypotension and thus enhance the hypotensive effects of propranolol.[pdr.net]
  • The concern with propranolol is that hypotension may lead to reduced cerebral blood flow and neurological consequences.[ncbi.nlm.nih.gov]
  • Three patients stopped the propranolol due to adverse effects: hypotension (2), nightmares (1). Severity of TD and duration of propranolol therapy were associated with response.[ncbi.nlm.nih.gov]
Slow Pulse
  • Some people may feel a little light-headed, sleepy, short-term memory loss, unusually slow pulse, lethargy, insomnia, diarrhea, cold hands and feet, numbness and/or tingling of fingers and toes. Dosages Recommended By Investigators.[anxieties.com]
  • Some people may feel a little light-headed, sleepy, short-term memory loss, unusually slow pulse, lethargy, insomnia, diarrhea, cold hands and feet, numbness and/or tingling of fingers and toes. Dosages Recommended By Investigators .[anxieties.com]
Purpura
  • , thrombocytopenic purpura Metabolic: fluid retention, hyperglycemia, hypoglycemia (increased in children), thyrotoxicosis (with abrupt withdrawal in hypertension therapy) Musculoskeletal: joint pain, back pain, myalgia, muscle cramps Respiratory: wheezing[medical-dictionary.thefreedictionary.com]
  • , purpura, alopecia , skin rashes, SLE-like reactions [ Ref ] Immunologic Postmarketing reports : Enhanced immune system [ Ref ] Propranolol can enhance the immune system by causing an increase in the number of circulating T cells, increased interleukin[drugs.com]
  • Skin: Purpura, alopecia, psoriasiform skin reactions, exacerbation of psoriasis, skin rashes. Neurological: Paraesthesia. Eyes: Dry eyes, visual disturbances.[medicines.org.uk]
  • Incidence not known thrombosis / Delayed / Incidence not known bronchospasm / Rapid / Incidence not known seizures / Delayed / Incidence not known coma / Early / Incidence not known hyperkalemia / Delayed / Incidence not known thrombotic thrombocytopenic purpura[pdr.net]
Alopecia
  • […] purpura, agranulocytosis , eosinophilia [ Ref ] Dermatologic Rare (less than 0.1%): Psoriatic flares Frequency not reported : Stevens - Johnson syndrome, toxic epidermal necrolysis , exfoliative dermatitis, erythema multiforme, urticaria , purpura, alopecia[drugs.com]
  • Skin: Purpura, alopecia, psoriasiform skin reactions, exacerbation of psoriasis, skin rashes. Neurological: Paraesthesia. Eyes: Dry eyes, visual disturbances.[medicines.org.uk]
  • […] known xerosis / Delayed / Incidence not known urticaria / Rapid / Incidence not known pruritus / Rapid / Incidence not known pharyngitis / Delayed / Incidence not known fever / Early / Incidence not known xerophthalmia / Early / Incidence not known alopecia[pdr.net]
Seizure
  • Vol. 1, Pg. 82, 1981. dog LDLo intraperitoneal 40mg/kg (40mg/kg) BEHAVIORAL: CONVULSIONS OR EFFECT ON SEIZURE THRESHOLD Pharmazie.[chem.nlm.nih.gov]
  • Seizure control will usually be established with benzodiazepines PRN. Phenytoin in many cases is ineffective in controlling further seizures. With IV access and airway and seizure control, circulation control and support becomes paramount.[resus.com.au]
  • Propranolol was the only beta blocker associated with seizure; of those who ingested more than 2 g of propranolol, two thirds had a seizure. There was a significant association between a QRS duration of 100 ms and risk of seizures.[doi.org]
  • It could be an allergic reaction if your child: has trouble breathing is not responsive has seizure-like activity after taking this medicine. Propranolol for Hemangiomas (PDF) HH- V-267 2/16 Copyright 2016, Nationwide Children's Hospital[nationwidechildrens.org]
  • Across all three data sources there were also 33 cases of low blood sugar, and four cases of fit (seizure) reported as a result.[discover.dc.nihr.ac.uk]

Workup

  • The patient was immediately administered propranolol hydrochloride, 40 mg twice a day, as his workup progressed and treatment options were elucidated.[ncbi.nlm.nih.gov]
Hypertriglyceridemia
  • […] rare (less than 0.01%): Hypoglycemia (particularly in neonates, infants, children, elderly patients, patients on hemodialysis , patients on concomitant antidiabetic therapy, patients with prolonged fasting and patients with chronic liver disease ), hypertriglyceridemia[drugs.com]
  • Icosapent ethyl: (Moderate) Beta-blockers may exacerbate hypertriglyceridemia and should be discontinued or changed to alternate therapy, if possible, prior to initiation of icosapent ethyl.[pdr.net]
Trypanosoma Cruzi
  • KEYWORDS: Host cell invasion; Metacyclic trypomastigote; Propranolol; Trypanosoma cruzi[ncbi.nlm.nih.gov]
Prolonged PR Interval
  • This can manifest as heart block, bradycardia, cardiac conduction abnormalities and/or prolonged PR interval. Congestive heart failure or severe hypotension also can occur.[pdr.net]
Third Degree Atrioventricular Block
  • ., asthma, bronchitis, emphysema ), diabetes, heart failure, certain types of heart rhythm problems ( sinus bradycardia, Wolff-Parkinson-White syndrome, second- or third-degree atrioventricular block), overactive thyroid ( hyperthyroidism ), kidney disease[webmd.com]
  • Patients with congestive heart failure, second- or third-degree atrioventricular block, bradycardia ( Study design Patients were submitted to a general clinical and physical examination before the investigation to exclude any important disease other than[scielo.br]

Treatment

  • We excluded infants who did not qualify for propranolol treatment and infants who received previous therapy or other treatments. The records were reviewed for treatment response, adverse events during treatment, length of treatment, and recurrences.[ncbi.nlm.nih.gov]
  • Age at treatment initiation, treatment time, thickness of the superficial component, and size of the lesions were shown to predict response to therapy.[ncbi.nlm.nih.gov]
  • We evaluated the therapeutic responses 6 months after treatment and the end of treatment, which were categorized into four grades. The type and location of the lesions and the infant age at treatment initiation were analysed.[ncbi.nlm.nih.gov]
  • Results: A total of 34 patients (15 boys, 19 girls; mean age, 3.3 months; range, 0.3-8.2 months) were randomized to receive either propranolol or steroid treatment (17 in each treatment group).[ncbi.nlm.nih.gov]
  • , and treatment side effects.[ncbi.nlm.nih.gov]

Prognosis

  • Generalized lymphangiectasia is a rare congenital disorder characterized by dilated lymphatic vessels with a fatal prognosis, especially in cases with thoracic involvement.[ncbi.nlm.nih.gov]
  • Despite the prognosis for eventual involution, infantile hemangiomas often cause great psychosocial morbidity that affects patients and their parents.[ncbi.nlm.nih.gov]
  • Weberpals J et al (2016) Beta blockers and cancer prognosis - The role of immortal time bias: A systematic review and meta-analysis Cancer Treat Rev 47 1–11 DOI: 10.1016/j.ctrv.2016.04.004 PMID: 27179912 79.[doi.org]

Etiology

  • Abstract Post HCV liver cirrhosis is one of the most prominent etiologies behind the abnormal portal circulation hemodynamics. It occurs as a result of distorted balance between portal venous flow (PVF) and intrahepatic resistances (IHR).[ncbi.nlm.nih.gov]
  • Gorham's syndrome is a rare illness of unknown etiology. It is characterized by a local proliferation of blood or lymphatic vessels that in bones leads to progressive resorption and destruction.[ncbi.nlm.nih.gov]
  • Despite significant morbidities, treatment options for LMs are inadequate because the etiology is poorly understood.[pediatrics.aappublications.org]
  • Age, sex, etiology of burn injury, burn to admission time, and duration of acute hospitalization were similar between cohorts (Table 1 ).[ccforum.biomedcentral.com]

Epidemiology

  • Epidemiologic, clinical, and treatment data, including effectiveness score and safety, were reviewed. RESULTS: The study included 63 patients with a total of 75 IHs.[ncbi.nlm.nih.gov]
  • Epidemiology, clinical features and treatment. CNS Drugs 1997 : 1221 – 1138. Google Scholar 16. Vieweg, WV, Godleskt, LS, Graham, P, Barber, J, Goldman, F, Kellogg, E, Bayliss, EV, Glick, J, Hundley, PL, Yank, GR.[doi.org]
  • Epidemiological and clinical studies have linked psychosocial factors such as chronic stress and depression with cancer progression and, to a lesser extent, cancer onset. 1 - 3 The results of experiments conducted in vitro confirm the assumption that[dx.doi.org]
Sex distribution
Age distribution

Pathophysiology

  • Neoangiogenesis secondary to von Willebrand factor degradation and increased vascular endothelial growth factor (VEGF) signalling is likely related to their pathophysiology.[ncbi.nlm.nih.gov]
  • The pathophysiological explanation relies on the mechanism of action of propranolol which seems to act initially with vasoconstriction, down-regulating proangiogenetic factors and inducing endothelial cell apoptosis.[ncbi.nlm.nih.gov]
  • Daniel Segelcke and Karl Messlinger, Putative role of 5-HT2B receptors in migraine pathophysiology, Cephalalgia, 37, 4, (365), (2017). T. S. Gan’shina, A. A. Gorbunov, A. V. Gnezdilova, A. I. Turilova, L. M. Kostochka, B. M. Pyatin, N. I.[doi.org]
  • Agitation and delirium are serious problems among critically ill patients, but the pathophysiology of delirium is not fully understood.[frontiersin.org]
  • Long-term persistance of the pathophysiologic response to severe burn injury. PLoS One. 2011;6, e21245. 5. Herndon DN, Rodriguez NA, Diaz EC, Hegde S, Jennings K, Mlcak RP, et al.[ccforum.biomedcentral.com]

Prevention

  • BACKGROUND AND AIMS: Band ligation and propranolol are the current therapies for primary prevention of variceal bleeding. Carvedilol is a rising nonselective beta-blocker used for reducing portal pressure with favorable outcome.[ncbi.nlm.nih.gov]
  • In this regard, early detection is mandatory for preventing the ominous consequences that might be culminated from the disease.[ncbi.nlm.nih.gov]
  • Taking in account propranolol's potential in preventing severe complications, further studies should assess the acceptability of propranolol treatment, especially in the[ncbi.nlm.nih.gov]
  • Propranolol is a beta blocker frequently prescribed to prevent certain types of migraine headaches.[verywellhealth.com]
  • This case suggests a protective role for propranolol in preventing the occurrence of new cerebral cavernoma with hemorrhages in adults with multiple CCM.[ncbi.nlm.nih.gov]

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