Inderal and asthma

Discussion in 'Rx Online' started by molse, 03-Sep-2019.

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    Inderal and asthma


    I recently was having palpitations and have been given propranolol. I know that it is usually not to be used if you have asthma, However, i also read that many athmatics can use it. I used it a long time ago when i was a teenager, before i developed asthma and it was great. Hello, I have tremors and my doctor prescribed me Inderal for only small dosage, because Propranolol increases the Asthma. Respiratory chest physician gives Theophylline Beta blocker may possibly arouse asthma. Also read from some websites that it can be quite dangerous. I asked him if tacking Inderal with Singulair would prevent the Asthma reaction but he asked me to check with an asthma specialist. Theophylline is not suitable for arrythmia patients. Basically, in the last two years I have been put through the merry go round of anti depressants. Is there any problems taking these 2 drugs together ? That means,,,,,,, I shall request cardiologist change my propranolol to other kinds medication, right? I was not happy to say the least with the outcome of all seven that I tried. One night I have heart racing again, then during my sleep my hands and heart feel numb, it shall be from my arrythmia or asthma? And yes, I tried each one of them for at least a month, most much longer. Every since I stopped them I have been coming around, and am feeling much better. Generally speaking the publications which support the increased risk of asthma exacerbation with beta blockers (BB) are based in old studies done mainly with propranolol. Boston Beta-2-Sympathomimetika wie Clenbuterol und Salmeterol, die seit Jahrzehnten zur Behandlung von Asthmaerkrankungen eingesetzt werden, bremsen in Hirnzellen die Bildung von Alpha-Synuclein, dessen Ablagerungen in Lewy-Krperchen zum Morbus Parkinson fhren. Die tierexperimentellen Ergebnisse in (2017; 357: 891898) werden durch epidemiologische Studien besttigt, wonach Asthmapatienten, die regelmig Clenbuterol oder Salmeterol anwenden, im Alter seltener an Morbus Parkinson erkranken. Viele Hirnforscher sehen heute in den Ablagerungen von Alpha-Synuclein in den Lewy-Krperchen, die ein histologisches Merkmal der Erkrankung sind, die eigentliche Ursache des Morbus Parkinson. Ein Beleg sind familire Erkrankungen, die durch die Duplikation oder andere Copy number mutations im SNCA-Gen ausgelst werden, das die Erbinformation fr das Protein Alpha-Synuclein enthlt. Medikamente, die den Abbau von Alpha-Synuclein frdern, sind deshalb ein aktueller Ansatz in der Arzneimittelforschung, der bisher jedoch nicht erfolgreich war. Ein Team um Clemens Scherzer von der Harvard Medical School in Boston ist einen anderen Weg gegangen. In einem speziellen Screening haben die Forscher nach Substanzen gesucht, die die Bildung von Alpha-Synuclein in den Hirnzellen hemmen knnten. Bei dem Screening von mehr als tausend Substanzen zeigten berraschenderweise die Beta-2-Sympathomimetika Clenbuterol, Salmeterol und Metaproterenol (Orciprenalin) eine hemmende Wirkung auf die Alpha-Synuclein-Produktion.

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    EDITOR,—The datasheet for Inderal propranolol states specifically that the drug is contraindicated in patients with asthma or a history of bronchospasm. Inderal® propranolol is a medicine that can worsen, but not cause, pre-existent asthma, can cause cough alone, without other signs of asthma, and can result in. Beta Blockers and Asthma/COPD Instructional Tutorial Video Video https//youtu.be/WRYCo-zrqcU.

    Prophylaxis 80 mg/day PO divided q6-8hr initially; may be increased by 20-40 mg/day every 3-4 weeks; not to exceed 160-240 mg/day divided q6-8hr Inderal LA: 80 mg/day PO; maintenance: 160-240 mg/day Withdraw therapy if satisfactory response not seen after 6 weeks Hemangeol: Indicated for treatment of proliferating hemangioma requiring systemic therapy Initiate treatment at aged 5 weeks to 5 months Starting dose: 0.6 mg/kg (0.15 m L/kg) PO BID for 1 week, THEN increase dose to 1.1 mg/kg (0.3 m L/kg) BID; after 2 more weeks, increase to maintenance dose of 1.7 mg/kg (0.4 m L/kg) BID PO: 0.5-1 mg/kg/day divided q6-8hr; may be increased every 3-7 days; usual range: 2-6 mg/kg/day; not to exceed 16 mg/kg/day or 60 mg/day IV: 0.01-0.1 mg/kg over 10 minutes; repeat q6-8hr PRN; not to exceed 1 mg for infants or 3 mg for children PO: 1 mg/kg/day divided q6hr; after 1 week, may be increased by 1 mg/kg/day to maximum of 10-15 mg/kg/day if patient refractory; allow 24 hours between dosing changes IV: 0.01-0.2 mg/kg over 10 minutes; not to exceed 5 mg Immediate-release: 40 mg PO q12hr initially, increased every 3-7 days; maintenance: 80-240 mg PO q8-12hr; not to exceed 640 mg/day Inderal LA: 80 mg/day PO initially; maintenance: 120-160 mg/day; not to exceed 640 mg/day Inno Pran XL: 80 mg/day PO initially; may be increased every 2-3 weeks until response achieved; maintenance: not to exceed 120 mg/day PO Consider lower initial dose PO: 10 mg q6-8hr; may be increased every 3-7 days IV: 1-3 mg at 1 mg/min initially; repeat q2-5min to total of 5 mg Once response or maximum dose achieved, do not give additional dose for at least 4 hours Aggravated congestive heart failure Bradycardia Hypotension Arthropathy Raynaud phenomenon Hyper/hypoglycemia Depression Fatigue Insomnia Paresthesia Psychotic disorder Pruritus Nausea Vomiting Hyperlipidemia Hyperkalemia Cramping Bronchospasm Dyspnea Pulmonary edema Respiratory distress Wheezing Allergic: Hypersensitivity reactions, including anaphylactic/anaphylactoid; agranulocytosis, erythematous rash, fever with sore throat Skin: Stevens-Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis, erythema multiforme, urticaria Musculoskeletal: Myopathy, myotonia May exacerbate ischemic heart disease after abrupt withdrawal Hypersensitivity to catecholamines has been observed during withdrawal Exacerbation of angina and, in some cases, myocardial infarction occurrence after abrupt discontinuance When discontinuing long-term administration of beta blockers (particularly with ischemic heart disease), gradually reduce dose over 1-2 weeks and carefully monitor If angina markedly worsens or acute coronary insufficiency develops, reinstate beta-blocker administration promptly, at least temporarily (in addition to other measures appropriate for unstable angina) Warn patients against interruption or discontinuance of beta-blocker therapy without physician advice Because coronary artery disease is common and may be unrecognized, slowly discontinue beta-blocker therapy, even in patients treated only for hypertension Asthma, COPD Severe sinus bradycardia or 2°/3° heart block (except in patients with functioning artificial pacemaker) Cardiogenic shock Uncompensated congestive heart failure Hypersensitivity Overt heart failure Sick sinus syndrome without permanent pacemaker Do not use Inno Pran XL in pediatric patients Long-term beta blocker therapy should not be routinely discontinued before 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 Use caution in bronchospastic disease, cerebrovascular insufficiency, congestive heart failure, diabetes mellitus, hyperthyroidism/thyrotoxicosis, liver disease, renal impairment, peripheral vascular disease, myasthenic conditions Sudden discontinuance can exacerbate angina and lead to myocardial infarction Use in pheochromocytoma Increased risk of stroke after surgery Hypersensitivity reactions, including anaphylactic and anaphylactoid reactions, have been reported Cutaneous reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis, erythema multiforme, and urticaria, have been reported Exacerbation of myopathy and myotonia has been reported Less effective than thiazide diuretics in black and geriatric patients May worsen bradycardia or hypotension; monitor HR and BP Avoid beta blockers without alpha1-adrenergic receptor blocking activity in patients with prinzmetal variant angina; unopposed alpha-1 adrenergic receptors may worsen anginal symptoms May induce or exacerbate psoriasis; cause and effect not established Prevents the response of endogenous catecholamines to correct hypoglycemia and masks the adrenergic warning signs of hypoglycemia, particularly tachycardia, palpitations, and sweating May cause or worsen bradycardia or hypotension Pregnancy category: C; intrauterine growth retardation, small placentas, and congenital abnormalities reported, but no adequate and well-controlled studies conducted Lactation: Use is controversial; an insignificant amount is excreted in breast milk Nonselective beta adrenergic receptor blocker; competitive beta1 and beta2 receptor inhibition results in decreases in heart rate, myocardial contractility, myocardial oxygen demand, and blood pressure Class 2 antidysrhythmic Bioavailability: 30-70% (food increases bioavailability) Onset: Hypertension, 2-3 wk; beta blockade, 2-10 min (IV) or 1-2 hr (PO) Duration: 6-12 hr (immediate release); 24-27 hr (extended release) Peak plasma time: 1-4 hr (immediate release); 6-14 hr (extended release) Solution: Most common solvents Additive: Dobutamine, verapamil Syringe: Inamrinone, milrinone Y-site: Alteplase, fenoldopam, gatifloxacin, heparin, hydrocortisone, sodium succinate, inamrinone, linezolid, meperidine, milrinone, morphine, potassium chloride, propofol, tacrolimus, tirofiban, vitamins B and C IV administration rate should not exceed 1 mg/min IV dose is much smaller than oral dose Give by direct injection into large vessel or into tubing of free-flowing compatible IV solution Continuous IV infusion generally is not recommended The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. While once a first-line treatment for hypertension, the role for beta blockers was downgraded in June 2006 in the United Kingdom to fourth-line, as they do not perform as well as other drugs, particularly in the elderly, and evidence is increasing that the most frequently used beta blockers at usual doses carry an unacceptable risk of provoking type 2 diabetes. Propranolol is not recommended for the treatment of hypertension by the Eighth Joint National Committee (JNC 8) because a higher rate of the primary composite outcome of cardiovascular death, myocardial infarction, or stroke compared to an angiotensin receptor blocker was noted in one study. Propranolol works to inhibit the actions of norepinephrine, a neurotransmitter that enhances memory consolidation. In one small study individuals given propranolol immediately after trauma experienced fewer stress-related symptoms and lower rates of PTSD than respective control groups who did not receive the drug. Due to the fact that memories and their emotional content are reconsolidated in the hours after they are recalled/re-experienced, propranolol can also diminish the emotional impact of already formed memories; for this reason, it is also being studied in the treatment of specific phobias, such as arachnophobia, dental fear, and social phobia. Ethical and legal questions have been raised surrounding the use of propranolol-based medications for use as a "memory damper", including: altering memory-recalled evidence during an investigation, modifying behavioral response to past (albeit traumatic) experiences, the regulation of these drugs, and others. However, Hall and Carter have argued that many such objections are "based on wildly exaggerated and unrealistic scenarios that ignore the limited action of propranolol in affecting memory, underplay the debilitating impact that PTSD has on those who suffer from it, and fail to acknowledge the extent to which drugs like alcohol are already used for this purpose." Propranolol may be used to treat severe infantile hemangiomas (IHs).

    Inderal and asthma

    Interaktionen Betablocker und Betasympathomimetika., Propranolol and asthma - MedHelp

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  3. Should Patients With Asthma Receive Beta-Blockers for Heart Problems? Darrell T. Hulisz, PharmD. concerns about nonselective agents such as propranolol inducing bronchospasm emerged in older.

    • Should Patients With Asthma Receive Beta-Blockers for Heart. - Medscape.
    • Beta Blockers and Asthma/COPD - YouTube.
    • Inderal LA Disease Interactions -.

    It is for all of these reasons that propranolol has been most studied and is the most commonly used beta-blocker in this setting.6-12 Doses of propranolol of 160 mg or more maybe needed to control symptoms, especially in younger patients with thyrotoxicosis.13 Interestingly, the American Association of Clinical Endocrinologists Medical. With the development of newer cardioselective beta-blockers, the risks are even less. Even so, care needs to be taken when beta-blockers are used in people with severe asthma or COPD to avoid potentially serious exacerbations. Beta-blockers in bronchial asthma effect of propranolol and pindolol on large and small airways.

     
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