普萘洛爾

用途

• Susceptible cardiac arrhythmias
• Susceptible cardiac arrhythmias
• Susceptible cardiac arrhythmias
• Adjunctive therapy in heart failure
• Adjunctive therapy of hypertension
• Adjunctive therapy in feline hyperthyroidism
• Hypertrophic cardiomyopathy
• Hypertrophic cardiomyopathy
• V-Tach
• V-Tach
• V-Tach
• Cardiac arrhythmias
• Cardiac arrhythmias
• Susceptible cardiac arrhythmias
• Susceptible cardiac arrhythmias
• Adjunctive therapy in heart failure
• Loud-noise phobias
• Tachycardia associated with serotonin syndrome

給藥方式

可能的副作用

• Bradycardia
• Lethargy and depression
• Impaired AV conduction
• Congestive heart failure (CHF) or worsening of heart failure
• Hypotension
• Syncope
• Diarrhea
• Hypoglycemia
• Bronchoconstriction
• AV block
• Myocardial depression
• Heart failure
• Hypoglycaemia
• Bronchospasm
• Diarrhoea
• Peripheral vasoconstriction
• Depression
• Lethargy

注意事項與禁忌

• Overt heart failure
• Hypersensitivity to beta-blockers
• Greater than 1st degree heart block
• Sinus bradycardia
• Congestive heart failure (unless secondary to a tachyarrhythmia responsive to beta-blockers)
• Bronchospastic lung disease (e.g., feline asthma)
• Bradyarrhythmias
• Acute or decompensated congestive heart failure
• Concurrent administration with alpha-adrenergic agonists (e.g., adrenaline)
• **Use with Caution:** * Patients with significant renal or hepatic insufficiency. * Patients with sinus node dysfunction. * Labile diabetic patients (can cause or mask clinical signs of hypoglycemia). * Digitalized or digitalis-intoxicated patients (severe bradycardia may result). * May mask clinical signs of thyrotoxicosis. * **Withdrawal:** If discontinuing the drug after chronic use, gradual withdrawal is recommended to prevent exacerbation of clinical signs.

藥物相互作用

• Antacids: May reduce oral propranolol absorption; separate doses by at least one hour
• Anesthetics, General: Additive myocardial depression may occur
• Anticholinergics: May negate cardiac effects of beta-blockers
• Calcium Channel Blockers: Concurrent use should be done with caution due to additive negative inotropic effects, particularly in patients with cardiomyopathy or CHF
• Cimetidine: May decrease the metabolism of propranolol and increase blood levels
• Diuretics: May increase risk for hypotension
• Epinephrine: Unopposed alpha effects of epinephrine may lead to rapid increases in blood pressure and decrease in heart rate
• Fluoxetine: May decrease propranolol metabolism; complete heart block reported in one human
• Insulin and Antidiabetic Drugs: Propranolol may prolong the hypoglycemic effects of insulin therapy
• Lidocaine: Clearance may be impaired by propranolol
• Methimazole, Propylthiouracil: Propranolol doses may need to be decreased when initiating therapy
• Phenobarbital: May increase the metabolism of propranolol
• Phenothiazines: May increase risk for hypotension
• Reserpine: May have additive effects with propranolol
• Succinylcholine, Tubocurarine: Effects may be enhanced with propranolol therapy
• Sympathomimetics: May have their actions blocked by propranolol
• Theophylline: Effects of theophylline (bronchodilation) may be blocked by propranolol
• Thyroid Hormones: May decrease the effects of beta blocking agents
• Anaesthetic agents: Enhanced hypotensive effect
• Antihypertensive drugs: Enhanced hypotensive effect
• Diazepam: Enhanced hypotensive effect
• Calcium-channel blockers: Increased risk of bradycardia, severe hypotension, heart failure, and AV block
• Digoxin: Potentiates bradycardia
• Carbimazole: May necessitate a decrease in propranolol dose when initiating therapy
• Aluminium hydroxide (oral): Reduces propranolol absorption
• Muscle relaxants (suxamethonium, tubocurarine): Enhances the effects of the muscle relaxants
• Phenytoin: Hepatic enzyme induction increases the rate of metabolism of propranolol
• Insulin: Propranolol may enhance the hypoglycaemic effect of insulin
• Adrenaline (Epinephrine): Concurrent use is contraindicated; risk of severe hypertension and bradycardia

常見問題