DRUG STUDY

Name of Patient:_________________________________________________________________________________________________________ Ward No.: _______ Bed No.: _______

Medical
Diagnosis:_______________________________________________________________________________________________________________________________________
Drug Name: PROPRANOLOL
Indication for Patient:
USUAL DOSAGE/
AVAILABILITY
Capsules (extendedrelease): 60 mg, 80mg,
120mg, 160mg
Injection: 1 mg/mL
Oral solution: 4mg/mL,
8mg/mL
Tablets: 10mg, 20mg,
40mg, 60mg, 80mg

PHARMACOLOGIC
ACTION OF DRUG
Reduces cardiac
oxygen demand by
blocking
catecholamineinduced increases in
heart rate, blood
pressure, and force of
myocardial
contraction. Drug
depresses renin
secretion and
prevents vasodilation
of cerebral arteries.

CONTRAINDICATIONS

INTERACTION

Abrupt withdrawal of drug may cause

exacerbation of angina or myocardial
infarction. To discontinue drug, gradually
reduce dosage over a few weeks. Because
coronary artery disease may be
unrecognized, dont discontinue drug
abruptly, even when taken for other
indications.
Contraindicated in patients with known
hypersensitivity to drug, bronchial asthma,
sinus bradycardia and heart block greater
than first degree, cardiogenic shock, and
overt and decompensated heart failure
(unless failure is secondary to a
tachyarrhythmia that can be treated with
propranolol).
Use cautiously in patients with hepatic or
renal impairment. Wolff-Parkinson-White
syndrome, nonallergic bronchospastic
diseases, or hepatic disease and in those
taking other antihypertensives.
Use cautiously in patients who have diabetes
mellitus because drug masks some

Drug-drug: Aminophylline: May antagonize betablocking effects of propranolol. Use together

cautiously.
Amiodarone, diltiazem, verapamil: May cause
hypotension, bradycardia, and increased depressant
effect on myocardium. Use together cautiously.
Cardiac glycosides: May reduce the positive inotrope
effect of the glycoside. Monitor patient for clinical
effect.
Cimetidine, Fluoxetine: May inhibit metabolism of
propranolol. Watch for increased beta-blocking effect.
Epinephrine: May cause severe vasoconstriction.
Monitor blood pressure and observe patient carefully.
Glucagon, isoproterenol: May antagonize propranolol
effect. May be used therapeutically and in
emergencies.
Haloperidol: May cause cardiac arrest. Avoid using
together.
Insulin, oral antidiabetics: May alter requirements for
these drugs in previously stabilized diabetics. Monitor
patient for hypoglycemia.
Lidocaine: May reduce clearance of lidocaine.
Monitor lidocaine level closely.

ADVERSE
EFFECTS
CNS: fatigue,
lethargy, fever,
vivid dreams,
hallucinations,
mental depression,
light-headedness,
dizziness,
insomnia.
CV: hypotension,
bradycardia, heart
failure,
intensification of
AV block,
intermittent
claudication.
GI: abdominal
cramping,
constipation,
diarrhea, nausea,
vomiting.
Hematologic:
agranulocytosis.
Respiratory:

DANICA PAULINE G. RAMOS|2012-63528

symptoms of hypoglycemia
In patients with thyrotoxicosis, use drug
cautiously because it may mask the signs
and symptoms. Abrupt withdrawal may
exacerbate symptoms of hyperthyroidism,
including thyroid storm.
Elderly patients may experience enhanced
adverse reactions and may need dosage
adjustment
Use cautiously in pregnant women because
drug may be associated with small placenta
and congenital anomalies.
Overdose S&Sx: Bradycardia, cardiac failure,
hypotension, bronchospasm

o
o
o

Phenothiazines (chlorpromazine, thioridazine): May

increase risk of serious adverse reactions of either
drug. Use with thioridazine is contraindicated. If
chlorpromazine must be used, monitor patients
pulse and blood pressure; decrease propranolol dose
as needed
Propafenone, quinidine: May increase propranolol
level. Monitor cardiac function, and adjust
propranolol dose as needed.
Drug-herb. Betel palm: May decrease temperatureelevating effects and enhanced CNS effects.
Discourage use together.
Ma-huang: May decrease antihypertensive effects.
Discourage use together.
Drug-lifestyle: Alcohol: May increase propranolol
level. Discourage alcohol use.
Cocaine use: May increase angina-inducing potential
of cocaine. Inform patient of this interaction.

bronchospasm.
Skin: Rash

NURSING RESPONSIBILITIES
Drug masks common signs and symptoms of shock and hypoglycemia
Monitor black patients for expected therapeutic effects; dosage adjustments may be necessary
Alert: Dont stop drug before surgery for pheochromocytoma. Before any surgical procedure, tell anesthesiologist that patient is receiving propranolol

DANICA PAULINE G. RAMOS|2012-63528