[1 tablet 5 cents]
- use as a centrally acting ‘beta blocker’
PRESENTATION AND ADMINISTRATION:
- PO Tablets:
Cardinol 10mg tablets (red) and 40mg (red)
- Long Acting Capsules:
Cardinol 160mg long acting capsules
Usual dosage for thyrotoxicosis, 10mg- 40mg 3-4 times a day; usual maximum dosage 320mg daily in divided doses
DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:
- Dose in renal impairment [GFR (ml/min)]
<10: start with small doses
10-20: start with small doses
>20-50: dose as in normal renal function
- Dose in renal replacement therapy
CAPD: start with small doses
HD: start with small doses
CVVHDF: start with small doses
DOSAGE IN PAEDIATRICS:
0.2-0.5mg/kg 6-12 hourly oral; slowly increase to 1.5mg/kg 6-12 hrly if required
- Propranolol hydrochloride is a synthetic non-selective beta-adrenergic receptor blocking agent. It is the first line agent for thyrotoxicosis because it reduces peripheral conversion of T4 to T3.
- sinus bradycardia
- heart block greater than first degree
- cardiogenic shock
- overt cardiac failure
- Cardiac Failure
Sympathetic stimulation is necessary in supporting circulatory function in congestive heart failure, and beta blockade carries the potential hazard of further depressing myocardial contractility and precipitating more severe failure.
- Discontinuation of therapy
Discontinuation of therapy in a patient with coronary artery disease may lead to rebound angina, arrhythmia or myocardial infarction.
- Diabetes and Hypoglycemia
Beta blockers may mask tachycardia occurring with hypoglycaemia.
Beta-adrenergic blockade may mask certain clinical signs (e.g., tachycardia) of hyperthyroidism. Abrupt withdrawal of beta blockade might precipitate a thyroid storm.
Beta blockers may aggravate peripheral arterial circulatory disorders.
- Laboratory Tests: No tests in addition to routine ICU tests are required
- Drug/Laboratory Test Interactions: None known
IMPORTANT DRUG INTERACTIONS FOR THE ICU
- Beta blockers may exacerbate the rebound hypertension which can follow the withdrawal of clonidine
- Body as a Whole:
- Cardiovascular System:
Bradycardia , Cold extremities, Hypotension, Leg pain
- Respiratory System:
- Digestive System:
- Nervous System:
Dizziness, Vertigo, Light-headedness