Propanolol concept map

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Enablers

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Pharmacodynamics

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Propanolol

side effects

overdose side effect: slow heartbeat

rash/swelling/hives/itching

difficulty breathing

constipation

diarrhea

tiredness

dizziness

abrupt withdrawal is associated with tachycardia, angina pectoris, and rarely myocardial infarction

drug interactions

anesthesia with epinephrine

blood pressure drugs: ACE inhibitors, other beta blockers, or alpha blockers

Blood thinning drugs

NSAIDS may reduce effectivness of drug

contraindications

severe low blood pressure

shock syndrome

Atrioventricular Valve block

bradycardia

COPD

smoking

indications

angina pectoris

arrythmia

coronary heart disease

hypertension

general dosages

80mg orally 1x/day

dental applications/considerations

oral lichenoid reaction

altered/loss sense of taste

xerostomia --> increased caries risk

used to reduce patient anxiety before extractions or post extractions to minimize dental-related apprehension. This practice has not been studied

Subtopic

monitor patient's vital signs throughout appointment and minimize any stressful activities that could elevate hypertensive patient's vitals

chronic propanolol therapy and lidocaine with epinephrine administration is associated with hypertensive blood pressure

function

reduce release of renin from juxtaglomerular apparatus

reduced sympathetic activity

reduce cardiac stroke volume

reduce heart rate

purpose

prevent strokes/myocardial infarction/cardiac arrythmias

nonselective Beta blocker

anti-hypertensive drug

pharmacodynamics

influence antisympathetic activity in CNS

is lipid soluble and crosses blood-brain barrier

sodium-channel blocking and prevents action potential propagation down an axon

blocks action of epinephrine and norepinephrine at Beta 1 and 2 adrenergic receptors

pharmokinetics

metabolites are excreted in urine

main metaoblite hydroxypropanolol is 5.2 to 7.5 hours

first pass metabolism: drug is metabolized at liver resulting in reduced systemic concentrations

>90% of drug is bound to plasma proteins in the blood

maximum plasma levels occurs 1-3 hours after ingestion

completely absorbed