Symptoms: bradycardia, dizziness or fainting, decreased blood pressure, arrhythmia, shortness of breath, cyanosis of nails of fingers or palms, cramps. Treatment: gastric lavage, the appointment of activated carbon, in violation of atrioventricular anadrol reviews conduction – intravenous 1-2 mg of atropine, epinephrine, when low efficiency of the formulation is carried out temporary pacemaker; with ventricular arrhythmia – lidocaine (IA class of drugs does not apply); arterial hypotension the patient should be in the Trendelenburg position. If there are no signs of pulmonary edema, intravenous plasma substituting solutions, with inefficiency – epinephrine, dopamine, dobutamine; in convulsions – diazepam intravenously; with bronchospasm inhalation or parenterally – beta adrenostimulyatorov.
Interaction with other drugs
The hypotensive effect of propranolol is enhanced when combined with diuretics, reserpine, hydralazine, and other antihypertensive agents, as well as ethanol.
The hypotensive effect of weakening the non-steroidal anti-inflammatory drugs (sodium retention and blockage of prostaglandin synthesis by the kidneys), estrogens (sodium retention) and MAO inhibitors .
cimetidine increases bioavailability.
increasing the concentration of lidocaine in the blood plasma, reduces the clearance of theophylline.
Simultaneous with the appointment phenothiazine derivatives increases concentration of both drugs in blood plasma.
increases the thyreostatic drugs and uterotoniziruyuschih; It reduces the effect of antihistamines.
It increases the likelihood of severe systemic reactions (anaphylaxis) due to the introduction of allergens used for immunotherapy or skin tests.
Amiodarone, verapamil and diltiazem – increased severity of negative chrono, foreign-and dromotropic actions of propranolol.
Iodinated radiopaque drugs for intravenous administration increases the risk of anaphylactic reactions.
Phenytoin intravenous administration, drugs for inhalation general anesthesia (derivatives of hydrocarbons) increase the intensity of cardiodepressive action and the likelihood of lowering blood pressure.
Changes the effectiveness of insulin and oral hypoglycemic drugs, masking the symptoms of developing hypoglycemia (tachycardia, high blood pressure).
Reduces clearance of xanthine (except dyphylline).
Antihypertensive effect of weakening glucocorticosteroids.
cardiac glycosides, methyldopa, reserpine and guanfacine, antiarrhythmic drugs increase the risk of developing or worsening bradycardia, atrioventricular block, cardiac arrest and heart failure.
Nifedipine can lead to a significant reduction in blood pressure.
Extends the action of non-depolarizing muscle relaxants and anticoagulant effect of coumarin.
tri- and tetracyclic antidepressants, antipsychotic drugs (neuroleptics), ethanol, sedatives and sleeping medications increase central nervous system depression.
not recommended simultaneous application with MAO inhibitors due to a significant increase hypotensive action, a break in treatment between receiving MAO inhibitors and propranolol should be at least 14 days.
Negidrirovannye ergot alkaloids increase the risk of peripheral circulatory disorders.
increases the thyreostatic uterotoniziruyuschih and medicines; reduces the effect of antihistamine drugs.
Sulfasalazine propranolol increases the concentration in plasma (inhibits metabolism), rifampicin shortened half-life.
monitoring patients receiving anadrol reviews obzidan should include monitoring of heart rate and blood pressure (at the beginning of treatment -Daily, then 1 every 3-4 months), the ECG.
In elderly patients, it is recommended to monitor renal function (1 times 4-5 months).
in the case of elderly patients increasing bradycardia (less than 50 beats per minute), hypotension (systolic blood pressure less than 100 mm Hg), atrioventricular block, bronchospasm, ventricular arrhythmias, severe liver dysfunction and / or kidney disease, it is necessary to reduce the dose or discontinue the treatment.
It is necessary to teach the patient the method of counting the heart rate and instructed to medical consultations at a heart rate less than 50 beats per minute.
It is recommended to discontinue therapy in the development of depression caused by the intake of beta-blockers.
patients who use contact lenses should bear in mind that during treatment may decrease the production of tear fluid.
Before the appointment obzidan patients with heart failure (early stages) should be used digitalis and / or diuretics.
treatment of ischemic heart disease and resistant hypertension should be prolonged – reception obzidan possible within a few years.
Discontinuation of treatment is carried out gradually, under the supervision of a physician: abrupt withdrawal can dramatically enhance myocardial ischemia, anginal syndrome worsen exercise capacity.
The lifting is carried out gradually, reducing the dose for 2 weeks or more (reduce dose 25% every 3-4 days).
diabetic patients using the product is carried out under the control of blood glucose content (1 every 4-5 months).
When thyrotoxicosis obzidan may mask certain clinical signs of hyperthyroidism (eg, tachycardia). Abrupt withdrawal is contraindicated in patients with thyrotoxicosis, anadrol reviews because the symptoms can increase. astralean