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Details:

Propranolol Hydrochloride is a non-selective beta-blocker used to treat cardiovascular conditions, anxiety, and other disorders. Here's a concise overview:

Classification

Class: Beta-adrenergic antagonist (blocks β? and β? receptors).

Mechanism: Reduces heart rate, blood pressure, and cardiac output by inhibiting adrenaline/noradrenaline effects. Also crosses the blood-brain barrier to alleviate anxiety and migraine symptoms.

Indications

1. Cardiovascular:

   • Hypertension, angina, arrhythmias (e.g., atrial fibrillation).

   • Secondary prevention post-heart attack.

2. Neurological:

   • Migraine prophylaxis, essential tremor.

3. Psychiatric:

   • Performance/social anxiety, situational anxiety.

4. Other:

   • Hyperthyroidism symptoms (e.g., tachycardia), portal hypertension.

Pharmacokinetics

Administration: Oral (tablets, extended-release) or IV (acute arrhythmias).

Bioavailability: ~25% (due to first-pass liver metabolism).

Half-life: 4–6 hours (dosed 2–4x daily); extended-release lasts 24 hours.

Metabolism: Hepatic (CYP2D6, CYP1A2 enzymes); active metabolite (4-hydroxypropranolol).

Dosage

Hypertension: 40–160 mg/day (divided doses).

Migraine: 20–240 mg/day.

Anxiety: 10–40 mg as needed (off-label).

Tapering: Required to avoid rebound hypertension/angina.

Side Effects

Common: Fatigue, dizziness, cold hands/feet, nausea, insomnia.

• Serious:

  • Bradycardia, heart failure exacerbation, bronchospasm (due to β? blockade).

  • Depression, hypoglycemia masking (in diabetics).

Contraindications

Asthma/COPD (risk of bronchospasm).

Severe bradycardia, heart block, decompensated heart failure.

Caution in diabetes, Raynaud’s syndrome, or liver impairment.

Drug Interactions

Calcium channel blockers (verapamil/diltiazem): Risk of heart block.

Insulin/oral hypoglycemics: Masks hypoglycemia symptoms (tremors, tachycardia).

NSAIDs: Reduce antihypertensive effect.

Special Populations

Pregnancy: Category C (use if benefits outweigh risks).

Lactation: Excreted in breast milk; monitor infant for bradycardia.

Brand Names & Availability

Prescription: Inderal®, Hemangeol® (infantile hemangioma), generics.

Cost: Low (generic is widely available).

Key Notes

Avoid abrupt discontinuation.

Non-selective β-blockade limits use in patients with respiratory conditions.

Off-label uses (e.g., anxiety) rely on CNS effects to reduce somatic symptoms (tremors, palpitations).