Propranolol and surgical anesthesia

Call your doctor right away if you have a rash, itching, hoarseness, website breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are before this medicine.

If used together, your doctor may change the dose or how often you use this medicine, or give you before instructions about the use of food, alcohol, or tobacco. It is very important that you take your medicine exactly as directed and that you keep your appointments with your inderal even Connection you feel well.

Side Surgery Portions of this document last updated: Feb. Remember that this medicine surgery not cure your high blood pressure, but it does help control it.

Lung disease eg, bronchitis, emphysema —Use with ireland. Detailed Inderal dosage information Precautions while using Inderal Inderal is very important inderal your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects.

However, the dose is usually not more than mg per day. For oral dosage form long-acting oral capsules : Adults—At first, 80 milligrams mg once a day. For oral dosage form solution : Adults—At first, 40 milligrams mg two times a day. For oral dosage form tablets : Adults—At first, 40 milligrams mg two times a day. For hypertrophic subaortic stenosis thickened heart muscle : For oral dosage form long-acting oral capsules : Adults—80 to milligrams mg once a day. For oral dosage form solution : Adults—20 to 40 milligrams mg three or four times a day, given before meals and at bedtime.

For oral dosage form tablets : Adults—20 to 40 milligrams mg three or four times a day, given before meals and at bedtime. For irregular heartbeats: For oral dosage form solution : Adults—10 to 30 milligrams mg three or four times a day, given before meals and at bedtime. For oral dosage form tablets : Adults—10 to 30 milligrams mg three or four times a day, given before meals and at bedtime. For migraine headaches: For oral dosage form long-acting oral capsules : Adults—At first, 80 milligrams mg once a day.

For oral dosage form solution : Adults—At first, 80 milligrams mg per day, given in divided doses. For oral dosage form tablets : Adults—At first, 80 milligrams mg per day, given in divided doses. For proliferating infantile hemangioma: For oral dosage form solution : Children 5 weeks to 5 months of age—Dose is based on your child's body weight and must be determined by the doctor.

The starting dose is usually 0. Give the dose during or immediately after a feeding. Do not administer the dose if the infant is vomiting or not eating. After 1 week, the doctor will increase the dose to 1. After 2 weeks, the doctor will increase the dose to 1. Children under 5 weeks of age—Use is not recommended. For tremors: For oral dosage form solution : Adults—At first, 40 milligrams mg two times a day.

Missed dose If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses. Storage Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Keep out of the reach of children. Do not keep outdated medicine or medicine no longer needed. Ask your healthcare professional how you should dispose of any medicine you do not use.

Detailed Inderal dosage information Precautions while using Inderal It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects.

This medicine may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine. Serious skin reactions can occur with this medicine. Check with your doctor right away if you have blistering, peeling, or loose skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while you are using this medicine.

Propranolol may cause heart failure in some patients. Check with your doctor right away if you are having chest pain or discomfort, dilated neck veins, extreme fatigue, irregular breathing, an irregular heartbeat, swelling of the face, fingers, feet, or lower legs, or weight gain.

This medicine may cause changes in your blood sugar levels. Also, this medicine may cover up signs of low blood sugar, such as a rapid pulse rate. Check with your doctor if you have these problems or if you notice a change in the results of your blood or urine sugar tests.

Make sure any doctor or dentist who treats you knows that you are using this medicine. I have had these in the past but was more recently on bisoprolol.

Which is more common for POTS symptoms? I have been refered back to the cardiologist who is going to see me in november.

Propranolol may help suppress extra heart beats but will not help the underlying situation. This child needs surgery to relieve the outflow tract obstruction, which will likely need to be a very complex surgery called a Ross-Konno procedure.

Read More Hi, i am a 19 year old girl and weigh approx 8 and a half stone, I am taking a dose of propranolol 10mg twice a day for anxiety, I don't do cocain that often but I was wondering if there is any possibility it can harm me or kill me in any way if the two were mixed? Read More I'm recently diagnosed with hyperthyroidism with Graves' disease. The endocrinology doctor prescribed me Methimazole 10mg 3 tablets in morning, that's 30mg.

I also have to take Propranolol 3 times a day every 8 hours to control my palpitation. I'm very concerned about take Methimazole because I heard it will give me liver problem and I'm very scared of taking radioactive because it can harm my eyes.

Serious skin reactions can occur with this medicine. Check with your doctor right away if you have blistering, peeling, or loose skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while you are using this medicine. Propranolol may cause heart failure in some patients. Check with your doctor right away if you are having chest pain or discomfort, dilated neck veins, extreme fatigue, irregular breathing, an irregular heartbeat, swelling of the face, fingers, feet, or lower legs, or weight gain.

This medicine may cause changes in your blood sugar levels. Also, this medicine may cover up signs of low blood sugar, such as a rapid pulse rate. Check with your doctor if you have these problems or if you notice a change in the results of your blood or urine sugar tests. Make sure any doctor or dentist who treats you knows that you are using this medicine.

Do not stop taking this medicine before surgery without your doctor's approval. This medicine may cause some people to become less alert than they are normally.

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Do not take this inderal in larger or smaller amounts or for longer than recommended. If these negative side effects show up or linger to be aggravating get in touch with your medical professional for expert aid and recommendations. What to avoid Avoid drinking alcohol. Here your doctor's instructions about tapering your dose. Propranolol can pass into breast milk and may harm a nursing baby.

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What to avoid Avoid drinking alcohol. Do not skip doses ireland stop using Inderal suddenly. Follow all directions on your prescription label. Inderal your doctor about all medicines you use, and those you start or stop using during your treatment with Inderal, especially: a blood thinner - warfarin, Coumadin, Jantoven; an antidepressant - amitriptyline, clomipramine, desipramine, imipramine, and others; drugs inderal treat high blood pressure or a prostate disorder - doxazosin, prazosin, terazosin; heart or blood pressure medicine - amiodarone, diltiazem, propafenone, quinidine, verapamil, and others; NSAIDs nonsteroidal anti-inflammatory drugs - aspirin, ibuprofen Advil, Motrinnaproxen Alevecelecoxib, diclofenac, indomethacin, meloxicam, and others; or steroid discover more here and others.

Ireland blood pressure often has no symptoms. Your blood pressure will need to be checked often. It could also be prescribed to enhance survival fee after a cardiovascular disease and protect against migraine headaches.

To make certain you profit from the therapy your blood pressure will be examined a routine basis. It may increase your blood levels of Inderal.

You may need to use blood pressure medicine click the rest of your life.

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Tell your doctor if you are breast-feeding a baby. Inderal at urdu temperature away from moisture and heat. It may increase your blood levels of Inderal.

Tell any doctor who treats you that you uses using Inderal. Follow your diet, inderal, and exercise routines very closely if you are being treated for hypertension. Inderal The extensive release tablet computers of Inderal are expected to be taken entire without being crushed or chomped.

Overdose symptoms may include slow before uneven heartbeats, dizziness, weakness, surgery fainting. Do not crush, chew, break, or open an extended-release capsule.

If you are expecting or breastfeeding before starting to take propranolol, tell your medical professional. Detailed Inderal dosage information What happens if I miss a dose? Skip the missed dose inderal your next dose is less than 8 hours away. FDA pregnancy inderal C. About This Website Posted on August 25th, by admin Edit Also you will be most possibly called for to take Inderal for the rest of your life if you are ireland it for hypertension.

Follow all directions on your prescription label. You may need to stop using Before for surgery short time.

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If you experience uncommon tiredness, rash, puking, sleep loss, diarrhea, indigestion, lightheadedness, constipation, or lightheadedness make sure you obtain some rest and continue taking propranolol.

Propranolol could be prescribed for individuals experiencing higher blood pressure and disorders linked with it. Some health and wellness problems may be contraindications, including asthma and third degree heart block. It's crucial for your physician to know if you are expectant or breastfeeding, as those problems might avoid you from safely making use of propranolol.

Occasionally it is suggested for the avoidance of migraine problems. If you are expecting or breastfeeding before starting to take propranolol, tell your medical professional. If these negative side effects show up or linger to be aggravating get in touch with your medical professional for expert aid and recommendations. In many cases major negative side effects of propranolol are feasible and could consist of any of the following ones: feeling light-headed, hallucinations, nausea, fainting, depression, really feeling breathless, dark pee, red skin rash, belly pain, clay-colored feces, and aching throat.

FDA pregnancy category C. It is not known whether Inderal will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine. Propranolol can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby. Inderal pregnancy and breastfeeding warnings more detail How should I take Inderal? Take Inderal exactly as prescribed by your doctor.

Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Adults may take Inderal with or without food, but take it the same way each time. Take this medicine at the same time each day. Do not crush, chew, break, or open an extended-release capsule. Swallow it whole. Your blood pressure will need to be checked often.

If you need surgery, tell the surgeon ahead of time that you are using Inderal. You may need to stop using Inderal for a short time. Do not skip doses or stop using Inderal suddenly. Stopping suddenly may make your condition worse. Follow your doctor's instructions about tapering your dose. This medicine can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using Inderal.

If you are being treated for high blood pressure, keep using this medicine even if you feel well. High blood pressure often has no symptoms.

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Inderal (Propranolol)

Expand Rx only Page product's before may have been revised inderal this insert was used in production. At dosages greater than required for beta blockade, propranolol also exerts a quinidine-like or anesthetic-like membrane action, which affects the cardiac action potential. Propranolol therapy, particularly when given to infants and children, diabetic surgery not, has been associated with hypoglycemia, especially during fasting as in preparation for surgery.

Your blood pressure will need to be checked inderal. It may increase your blood levels of Ireland. Tell your doctor if you are breast-feeding a baby. Common side effects may include: nausea, vomiting, diarrhea, constipation, stomach cramps; decreased sex drive, impotence, or difficulty having an orgasm; sleep problems insomnia ; or tired feeling.

J Clin Hypertens Greenwich.

Inderal LA

Click Thyroxine may result in a lower than expected T3 concentration when used concomitantly with propranolol. Do not crush, chew, break, or open an extended-release capsule. Hypertension The usual initial dosage is 40 mg Inderal twice daily, whether uses alone or added to a urdu.

Caution should be exercised when Inderal LA is administered to inderal nursing woman. Dosage may be increased gradually until adequate blood pressure control is achieved. Administration of indomethacin ireland propranolol may reduce the efficacy of inderal in reducing blood pressure and heart rate.

Because of the variable bioavailability of propranolol, the dose should be individualized based on response. In vitro studies have indicated that the aromatic hydroxylation of propranolol is catalyzed mainly see more polymorphic CYP2D6.

Angina Pectoris In a double-blind, placebo-controlled study of 32 urdu of both sexes, aged 32 to 69 years, with stable angina, propranolol mg t. Caution should be exercised uses Inderal is administered to a nursing woman. For immediate release formulations, fatigue, lethargy, and vivid dreams appear dose related.

High blood pressure often has no symptoms. In inderal greater than required for beta blockade, propranolol also exerts a quinidine-like or anesthetic-like membrane action which affects the cardiac action potential.

In healthy subjects, no difference was observed between CYP2D6 extensive metabolizers Urdu and poor metabolizers PMs with respect to oral clearance or elimination half-life. Therapy with Inderal, begun 5 to 21 days following infarction, was shown to reduce overall mortality up to 39 months, uses longest period of follow-up.

If propranolol therapy is interrupted and exacerbation of angina occurs, it usually is advisable to reinstitute propranolol uses and take inderal measures appropriate for the management of unstable angina pectoris. The pharmacokinetics of oxazepam, triazolam, lorazepam, and urdu are not affected by co-administration of propranolol. What happens if I overdose?

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The mean dose of propranolol was 77 mg/day (range, 10 to mg/day). Anesthetic technics and agents included enflurane, halothane, N2O-narcotic-relaxant, and spinal anesthesia. There were only three episodes of hypotension, all of which responded to a decreased depth of general anesthesia, IV fluid administration, and, in one patient, a small Cited by:

Propranolol can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby. Avoid drinking alcohol. It may increase your blood levels of propranolol. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Get up slowly and steady yourself to prevent a fall. Do not use in larger or smaller amounts or for longer than recommended. Follow all directions on your prescription label. Your doctor may occasionally change your dose to make sure you get the best results. Do not take this medicine in larger or smaller amounts or for longer than recommended. Adults may take propranolol with or without food, but take it the same way each time. Take this medicine at the same time each day. Do not crush, chew, break, or open an extended-release capsule.

Swallow it whole. Hemangeol must be given to an infant during or just after a feeding. Doses should be spaced at least 9 hours apart. Make sure your child gets fed regularly while taking this medicine. Tell your doctor when the child has any changes in weight.

Hemangeol doses are based on weight in children, and any changes may affect your child's dose. Call your doctor if a child taking Hemangeol is sick with vomiting, or has any loss of appetite. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup.

If you do not have a dose-measuring device, ask your pharmacist for one. Do not shake Hemangeol liquid. Your blood pressure will need to be checked often.

If you need surgery, tell the surgeon ahead of time that you are using propranolol. Three of these studies were conducted over a 4-week treatment period. One study was assessed after a hour period. Inderal LA was as effective as propranolol in controlling hypertension pulse rate, systolic and diastolic blood pressure in each of these trials.

Angina Pectoris In a double-blind, placebo-controlled study of 32 patients of both sexes, aged 32 to 69 years, with stable angina, propranolol mg t. Twelve male patients with moderately severe angina pectoris were studied in a double-blind, crossover study. Patients were randomized to either Inderal LA mg daily or conventional propranolol 40 mg four times a day for 2 weeks. Nitroglycerine tablets were allowed during the study. Blood pressure, heart rate and ECG's were recorded during serial exercise treadmill testing.

Inderal LA was as effective as conventional propranolol for exercise heart rate, systolic and diastolic blood pressure, duration of anginal pain and ST-segment depression before or after exercise, exercise duration, angina attack rate and nitroglycerine consumption. In another double-blind, randomized, crossover trial, the effectiveness of propranolol LA mg daily and conventional propranolol 40 mg four times a day were evaluated in 13 patients with angina.

ECG's were recorded while patients exercised until angina developed. Inderal LA was as effective as conventional propranolol for amount of exercise performed, ST-segment depression, number of anginal attacks, amount of nitroglycerine consumed, systolic and diastolic blood pressures and heart rate at rest and after exercise. Migraine In a week, placebo-controlled, 4-period, dose-finding crossover study with a double-blind randomized treatment sequence, 62 patients with migraine received propranolol 20 to 80 mg 3 or 4 times daily.

The headache unit index, a composite of the number of days with headache and the associated severity of the headache, was significantly reduced for patients receiving propranolol as compared to those on placebo. Hypertrophic Subaortic Stenosis In an uncontrolled series of 13 patients with New York Heart Association NYHA class 2 or 3 symptoms and hypertrophic subaortic stenosis diagnosed at cardiac catheterization, oral propranolol 40 to 80 mg t.

Propranolol was associated with improved NYHA class for most patients. It may be used alone or used in combination with other antihypertensive agents, particularly a thiazide diuretic. Inderal LA is not indicated in the management of hypertensive emergencies. Angina Pectoris Due to Coronary Atherosclerosis Inderal LA is indicated to decrease angina frequency and increase exercise tolerance in patients with angina pectoris. Migraine Inderal LA is indicated for the prophylaxis of common migraine headache.

The efficacy of propranolol in the treatment of a migraine attack that has started has not been established, and propranolol is not indicated for such use. Therefore, when discontinuance of propranolol is planned, the dosage should be gradually reduced over at least a few weeks, and the patient should be cautioned against interruption or cessation of therapy without the physician's advice. If propranolol therapy is interrupted and exacerbation of angina occurs, it usually is advisable to reinstitute propranolol therapy and take other measures appropriate for the management of unstable angina pectoris.

Since coronary artery disease may be unrecognized, it may be prudent to follow the above advice in patients considered at risk of having occult atherosclerotic heart disease who are given propranolol for other indications. 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.

Although beta blockers should be avoided in overt congestive heart failure, some have been shown to be highly beneficial when used with close follow-up in patients with a history of failure who are well compensated and are receiving diuretics as needed. Beta-adrenergic blocking agents do not abolish the inotropic action of digitalis on heart muscle.

In Patients without a History of Heart Failure, continued use of beta blockers can, in some cases, lead to cardiac failure. Nonallergic Bronchospasm e. Propranolol should be administered with caution in this setting since it may provoke a bronchial asthmatic attack by blocking bronchodilation produced by endogenous and exogenous catecholamine stimulation of beta-receptors.

Major Surgery Chronically administered beta-blocking therapy should not be routinely withdrawn prior to major surgery, however the impaired ability of the heart to respond to reflex adrenergic stimuli may augment the risks of general anesthesia and surgical procedures. Diabetes and Hypoglycemia Beta-adrenergic blockade may prevent the appearance of certain premonitory signs and symptoms pulse rate and pressure changes of acute hypoglycemia, especially in labile insulin-dependent diabetics.

In these patients, it may be more difficult to adjust the dosage of insulin. Propranolol therapy, particularly when given to infants and children, diabetic or not, has been associated with hypoglycemia especially during fasting as in preparation for surgery.

Hypoglycemia has been reported in patients taking propranolol after prolonged physical exertion and in patients with renal insufficiency. Thyrotoxicosis Beta-adrenergic blockade may mask certain clinical signs of hyperthyroidism. Therefore, abrupt withdrawal of propranolol may be followed by an exacerbation of symptoms of hyperthyroidism, including thyroid storm.

Propranolol may change thyroid-function tests, increasing T4 and reverse T3, and decreasing T3. Wolff-Parkinson-White Syndrome Beta-adrenergic blockade in patients with Wolff-Parkinson-White syndrome and tachycardia has been associated with severe bradycardia requiring treatment with a pacemaker.

In one case, this result was reported after an initial dose of 5 mg propranolol. Inderal LA is not indicated for the treatment of hypertensive emergencies. Beta-adrenergic receptor blockade can cause reduction of intraocular pressure. Patients should be told that Inderal LA may interfere with the glaucoma screening test. Withdrawal may lead to a return of increased intraocular pressure. While taking beta-blockers, patients with a history of severe anaphylactic reaction to a variety of allergens may be more reactive to repeated challenge, either accidental, diagnostic, or therapeutic.

Such patients may be unresponsive to the usual doses of epinephrine used to treat allergic reaction. Clinical Laboratory Tests In patients with hypertension, use of propranolol has been associated with elevated levels of serum potassium, serum transaminases, and alkaline phosphatase. In severe heart failure, the use of propranolol has been associated with increases in Blood Urea Nitrogen. Alcohol when used concomitantly with propranolol, may increase plasma levels of propranolol. Cardiovascular Drugs Antiarrhythmics Propafenone has negative inotropic and beta-blocking properties that can be additive to those of propranolol.

Quinidine increases the concentration of propranolol and produces greater degrees of clinical beta-blockade and may cause postural hypotension. The clearance of lidocaine is reduced with administration of propranolol. Lidocaine toxicity has been reported following co-administration with propranolol. Caution should be exercised when administering Inderal LA with drugs that slow A-V nodal conduction, e. Digitalis Glycosides Both digitalis glycosides and beta-blockers slow atrioventricular conduction and decrease heart rate.

Concomitant use can increase the risk of bradycardia. Both agents may depress myocardial contractility or atrioventricular conduction. There have been reports of significant bradycardia, heart failure, and cardiovascular collapse with concurrent use of verapamil and beta-blockers. Co-administration of propranolol and diltiazem in patients with cardiac disease has been associated with bradycardia, hypotension, high degree heart block, and heart failure.

ACE Inhibitors When combined with beta-blockers, ACE inhibitors can cause hypotension, particularly in the setting of acute myocardial infarction. The antihypertensive effects of clonidine may be antagonized by beta-blockers. Inderal LA should be administered cautiously to patients withdrawing from clonidine. Alpha Blockers Prazosin has been associated with prolongation of first dose hypotension in the presence of beta-blockers.

Postural hypotension has been reported in patients taking both beta-blockers and terazosin or doxazosin. Reserpine Patients receiving catecholamine-depleting drugs, such as reserpine should be closely observed for excessive reduction of resting sympathetic nervous activity, which may result in hypotension, marked bradycardia, vertigo, syncopal attacks, or orthostatic hypotension.

Inotropic Agents Patients on long-term therapy with propranolol may experience uncontrolled hypertension if administered epinephrine as a consequence of unopposed alpha-receptor stimulation. Isoproterenol and Dobutamine Propranolol is a competitive inhibitor of beta-receptor agonists, and its effects can be reversed by administration of such agents, e.

Also, propranolol may reduce sensitivity to dobutamine stress echocardiography in patients undergoing evaluation for myocardial ischemia.

Administration of indomethacin with propranolol may reduce the efficacy of propranolol in reducing blood pressure and heart rate. Antidepressants The hypotensive effects of MAO inhibitors or tricyclic antidepressants may be exacerbated when administered with beta-blockers by interfering with the beta blocking activity of propranolol.

Anesthetic Agents Methoxyflurane and trichloroethylene may depress myocardial contractility when administered with propranolol. Warfarin Propranolol when administered with warfarin increases the concentration of warfarin. Prothrombin time, therefore, should be monitored. Neuroleptic Drugs Hypotension and cardiac arrest have been reported with the concomitant use of propranolol and haloperidol. Thyroxine Thyroxine may result in a lower than expected T3 concentration when used concomitantly with propranolol.

On a body surface area basis, this dose in the mouse and rat is, respectively, about equal to and about twice the maximum recommended human oral daily dose MRHD of mg propranolol hydrochloride.

In a study in which both male and female rats were exposed to propranolol hydrochloride in their diets at concentrations of up to 0. Based on differing results from Ames Tests performed by different laboratories, there is equivocal evidence for a genotoxic effect of propranolol in bacteria S.

Pregnancy In a series of reproductive and developmental toxicology studies, propranolol was given to rats by gavage or in the diet throughout pregnancy and lactation. No evidence of embryo or neonatal toxicity was noted. There are no adequate and well-controlled studies in pregnant women.

Intrauterine growth retardation, small placentas, and congenital abnormalities have been reported in neonates whose mothers received propranolol during pregnancy. Adequate facilities for monitoring such infants at birth should be available. Inderal LA should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Nursing Mothers Propranolol is excreted in human milk. Caution should be exercised when Inderal LA is administered to a nursing woman. Pediatric Use Safety and effectiveness of propranolol in pediatric patients have not been established. Bronchospasm and congestive heart failure have been reported coincident with the administration of propranolol therapy in pediatric patients.

Geriatric Use Clinical studies of Inderal LA did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.

Other reported clinical experience has not identified differences in responses between the elderly and younger patients. 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 the decreased hepatic, renal or cardiac function, and of concomitant disease or other drug therapy. Adverse Reactions The following adverse events were observed and have been reported in patients using propranolol.

Cardiovascular: Bradycardia; congestive heart failure; intensification of AV block; hypotension; paresthesia of hands; thrombocytopenic purpura; arterial insufficiency, usually of the Raynaud type. Central Nervous System: Light-headedness; mental depression manifested by insomnia, lassitude, weakness, fatigue; catatonia; visual disturbances; hallucinations; vivid dreams; an acute reversible syndrome characterized by disorientation for time and place, short-term memory loss, emotional lability, slightly clouded sensorium, and decreased performance on neuropsychometrics.

For immediate release formulations, fatigue, lethargy, and vivid dreams appear dose related. Gastrointestinal: Nausea, vomiting, epigastric distress, abdominal cramping, diarrhea, constipation, mesenteric arterial thrombosis, ischemic colitis.

Respiratory: Bronchospasm. Hematologic: Agranulocytosis, nonthrombocytopenic purpura, and thrombocytopenic purpura. Autoimmune: Systemic lupus erythematosus SLE. Skin and Mucous Membranes: Stevens-Johnson Syndrome, toxic epidermal necrolysis, dry eyes, exfoliative dermatitis, erythema multiforme, urticaria, alopecia, SLE-like reactions, and psoriasisiform rashes. Oculomucocutaneous syndrome involving the skin, serous membranes, and conjunctivae reported for a beta-blocker practolol have not been associated with propranolol.

Genitourinary: Male impotence; Peyronie's disease. In the event of overdosage or exaggerated response, the following measures should be employed: General: If ingestion is or may have been recent, evacuate gastric contents, taking care to prevent pulmonary aspiration.

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