济民药业,关爱无限 www.pidrug.com
香港济民药业微信二维码
198 9654 1773
当前位置:首页 > 药品资讯 > 精神科 > 普萘洛尔propranolol

普萘洛尔propranolol

[ 人气:50 | 日期: 2020-08-04 | 返回 | 打印 ]
普萘洛尔propranolol
药品名称:普萘洛尔propranolol
药品别名:心得安 、恩特来
英 文 名:propranolol
药品价格:$ 美国市场售价 25.1 美元
研发公司:
适 用 症:可治疗心律失常、心绞痛、高血压。
型号规格:20mg/5mL和40mg/5mL两种规格。
药品详情:

【普萘洛尔propranolol 简述】
 
    普萘洛尔propranolol又名心得安 、恩特来。本品为β肾上腺素受体阻断药(β阻滞剂),阻断心肌的β受体,减慢心率,抑制心脏收缩力与房室传导,循环血流量减少,心肌氧耗量降低。它可抑制肾素的释放,故血浆肾素的浓度下降。

普萘洛尔propranolol_香港济民药业
 
【普萘洛尔propranolol 适应症】
 
    可治疗心律失常、心绞痛、高血压。亦可用于甲状腺机能亢进症,能迅速控制心动过速、震颤、体温升高等症状。
 
【普萘洛尔propranolol 规格】
 
    20mg/5mL和40mg/5mL两种规格。
 
【普萘洛尔propranolol 服用方法】
 
    口服:治疗各种心律失常,10mg/次,一天3次。
 
  治疗心绞痛:40~80mg/d,分3-4次服用。
 
  治疗高血压:5mg/次,一天4次,1-2周后增加1/4量,在严密观察下每日量可逐渐增加至100mg。
 
【普萘洛尔propranolol 注意事项】
 
  ⑴该品可通过胎盘进入胎儿体内,有报道妊娠高血压者用后可致宫内胎儿发育迟缓,分娩时无力造成难产,新生儿可产生低血压、低血糖、呼吸抑制及心率减慢,尽管也有报告对母亲及胎儿均无影响,但必须权衡利弊,不宜作为孕妇第一线治疗药物。
 
  ⑵可从乳汁分泌小量,故哺乳期妇女应用必须权衡利弊。
 
  ⑶老年人对该品代谢与排泄能力低,应适当调节剂量。
 
  ⑷下列情况应禁用:①支气管哮喘;②心源性休克;③心传导阻滞(Ⅱ至Ⅲ度房室传导阻滞);④重度心力衰竭;⑤窦性心动过缓。
 
  ⑸下列情况应慎用:①过敏史;②充血性心力衰竭;③糖尿病;④肺气肿或非过敏性支气管炎;⑤肝功能不全;⑥甲状腺功能低下;⑦雷诺综合征或其他周围血管疾病;⑧肾功能减退。
 
【普萘洛尔propranolol 不良反应】
 
    由于该品能透入神经系统,故可出现中枢神经系统不良反应。①较常见的有眩晕或头昏(低血压所致)、心率过慢(<50次/分钟);②较少见的有支气管痉挛及呼吸困难、充血性心力衰竭、神志模糊(尤见于老年人)、精神抑郁,反应迟钝;③更少见的有发热和咽痛(粒细胞缺乏)、皮疹(过敏反应)、出血倾向(血小板减小);④不良反应持续存在时,须格外警惕的有四肢冰冷、腹泻、倦怠、眼口或皮肤干燥、恶心、指趾麻木、异常疲乏等。
 
  应严密观察血压及心律变化,如心律变慢,立即停药.乏力,嗜睡,头晕,失眠,恶心,皮疹. 个别病例有周身性红斑狼疮样反应,多关节病综合症,幻视,性功能障碍(或性欲下降).剂量过大时引起低血压(血压下降),心动过缓,惊厥,呕吐. 可诱发缺血性脑梗塞,可有心源性休克,甚至死亡。
 
  它可引起哮喘;可发生Ⅰ型过敏反应及Ⅳ型迟发过敏反应颇似Lyell综合征;可出现荨麻疹、牛皮癣样皮疹。有报告可发生过敏性肺炎;脱发;及致有硬化性腹膜炎。
 
  此药的停药反应并不限于心血管,也常见有头痛、震颤及焦虑,有时也可出现精神异常。

 
Inderal(propranolol)

Propranolol, sold under the brand name Inderal among others, is a medication of the beta blocker class.[1] It is used to treat high blood pressure, a number of types of irregular heart rate, thyrotoxicosis, capillary hemangiomas, performance anxiety, and essential tremors.[1][2][3] It is used to prevent migraine headaches, and to prevent further heart problems in those with angina or previous heart attacks.[1] It can be taken by mouth or by injection into a vein.[1] The formulation that is taken by mouth comes in short-acting and long-acting versions.[1] Propranolol appears in the blood after 30 minutes and has a maximum effect between 60 and 90 minutes when taken by mouth.[1][4]
 
Common side effects include nausea, abdominal pain, and constipation.[1] It should not be used in those with an already slow heart rate and most of those with heart failure.[1] Quickly stopping the medication in those with coronary artery disease may worsen symptoms.[1] It may worsen the symptoms of asthma.[1] Caution is recommended in those with liver or kidney problems.[1] Propranolol may cause harmful effects in the baby if taken during pregnancy.[5] Its use during breastfeeding is probably safe, but the baby should be monitored for side effects.[6] It is a non-selective beta blocker which works by blocking β-adrenergic receptors.[1]
 
Propranolol was patented in 1962 and approved for medical use in 1964.[7] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[8] Propranolol is available as a generic medication.[1] The wholesale cost in the developing world is between US$0.24 and US$2.16 per month as of 2014.[9] In the United States it costs about $15 per month at a typical dose.[1] In 2016 it was the 43rd most prescribed medication in the United States with more than 18 million prescriptions.[10]
 
Medical uses
 
Propranolol is used for treating various conditions, including:
 
Cardiovascular
 
§                                 Hypertension
§                                 Angina pectoris (with the exception of variant angina)
§                                 Myocardial infarction
§                                 Tachycardia (and other sympathetic nervous system symptoms, such as muscle tremor) associated with various conditions, including anxiety, panic, hyperthyroidism, and lithium therapy
§                                 Portal hypertension, to lower portal vein pressure
§                                 Prevention of esophageal variceal bleeding and ascites
§                                 Anxiety
§                                 Hypertrophic cardiomyopathy
 
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.[11]
 
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.[12]
 
Psychiatric
 
Propranolol is occasionally used to treat performance anxiety.[2] Evidence to support its use in other anxiety disorders is poor.[13] Some experimentation has been conducted in other psychiatric areas:[14]
 
§                                 Post-traumatic stress disorder (PTSD) and specific phobias (see subsection below)
§                                 Aggressive behavior of patients with brain injuries[15]
§                                 Treating the excessive drinking of fluids in psychogenic polydipsia[16][17]
 
PTSD and phobias
 
Propranolol is being investigated as a potential treatment for PTSD.[18][19] 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.[20] 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.[21]
 
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.[22] 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."[23]
 
Others
 
§                                 Essential tremor. Evidence for use for akathisia however is insufficient[24]
§                                 Migraine and cluster headache prevention[25][26] and in primary exertional headache[27]
§                                 Hyperhidrosis (excessive sweating)
§                                 Proliferating infantile hemangioma
§                                 Glaucoma
§                                 Thyrotoxicosis by deiodinase inhibition
 
Propranolol may be used to treat severe infantile hemangiomas (IHs). This treatment shows promise as being superior to corticosteroids when treating IHs. Extensive clinical case evidence and a small controlled trial support its efficacy.[28]
 
Contraindications
 
Propranolol may be contraindicated in people with:[29]
§                                 Reversible airways diseases, particularly asthma or chronic obstructive pulmonary disease (COPD)
§                                 Slow heart rate (bradycardia) (<60 beats/minute)
§                                 Sick sinus syndrome
§                                 Atrioventricular block (second- or third-degree)
§                                 Shock
§                                 Severe low blood pressure
§                                 Cocaine toxicity [per American Heart Association guidelines, 2005]
 
Adverse effects
 
Propranolol should be used with caution in people with:[29]
 
§                                 Diabetes mellitus or hyperthyroidism, since signs and symptoms of hypoglycaemia may be masked
§                                 Peripheral vascular disease and Raynaud's syndrome, which may be exacerbated
§                                 Phaeochromocytoma, as hypertension may be aggravated without prior alpha blocker therapy
§                                 Myasthenia gravis, which may be worsened
§                                 Other drugs with bradycardic effects
 
Pregnancy and lactation
 
Propranolol, like other beta blockers, is classified as pregnancy category C in the United States and ADEC category C in Australia. β-blocking agents in general reduce perfusion of the placenta, which may lead to adverse outcomes for the neonate, including lung or heart complications, or premature birth. The newborn may experience additional adverse effects such as low blood sugar and a slower than normal heart rate.[30]
 
Most β-blocking agents appear in the milk of lactating women. However, propranolol is highly bound to proteins in the bloodstream and is distributed into breast milk at very low levels.[31] These low levels are not expected to pose any risk to the breastfeeding infant, and the American Academy of Pediatrics considers propranolol therapy "generally compatible with breastfeeding".[30][31][32][33]
 
Due to the high penetration across the blood–brain barrier, lipophilic beta blockers such as propranolol and metoprolol are more likely than other less lipophilic beta blockers to cause sleep disturbances such as insomnia and vivid dreams, and nightmares.[34] Dreaming (rapid eye movement sleep, REM) was reduced and increased awakening.[35][needs update]
Adverse drug reactions associated with propranolol therapy are similar to other lipophilic beta blockers.
 
Overdose
 
In overdose propranolol is associated with seizures.[36] Cardiac arrest may occur in propranolol overdose due to sudden ventricular arrhythmias, or cardiogenic shock which may ultimately culminate in bradycardic PEA.[37] Propranolol should be used with extreme caution in depressed or atypically depressed patients with possible suicidal ideation.[citation needed]
 
Mechanism of action
 
Propranolol is a competitive antagonist of beta-1-adrenergic receptors in the heart.[65] It competes with sympathomimetic neurotransmitters for binding to receptors, which inhibits sympathetic stimulation of the heart. Blockage of neurotransmitter binding to beta 1 receptors on cardiac myocytes inhibits activation of adenylate cyclase, which in turn inhibits cAMP synthesis leading to reduced PKA production. This results in less calcium influx to cardiac myocytes through voltage gated L-type calcium channels meaning there is a decreased sympathetic effect on cardiac cells, resulting in antihypertensive effects including reduced heart rate and lower arterial blood pressure.[66]
 
 
 



注:药品如有新包装,以新包装为准。以上资讯仅供医护人员内部讨论,不作任何用药依据,具体用药指引,请咨询主治医师。

更多相关资讯:返回顶部
最新药品资讯
  • 2020年第四季度有望获美国FDA批准上市的十余款新药
  • EYSUVIS获美国FDA批准用于干眼症的短期治疗!
  • 中国NMPA批准Tecentrip+Avastin联合一线治疗肝细胞癌(HCC)!
  • 罗米司亭Romiplostim对骨髓增生异常综合征治疗效果怎么样?
  • 血癌新药︰维奈妥拉VENCLYXTO
  • 哪种患者使用Tagrix奥西替尼(9291)更高效?
  • 罗米司亭Romiplostim治疗儿童免疫性血小板减少症(ITP),疗效如何?
  • 布地奈德Budesonide加入盐水鼻腔灌洗液,对慢性鼻窦炎有更多临床益处
  • 下列3款治疗胸腺癌的靶向药如下
  • 美国FDA批准Veklury(瑞德西韦)治疗新冠病毒感染(COVID-19)!是美国唯一一个被批准的COVID-19治疗药物!
  • 强生Xarelto(rivaroxaban,利伐沙班)向FDA提交新适应症申请,用于急性医学疾病患者预防静脉血栓栓塞!
  • 利伐沙班(Xarelto)适应症是什么?有啥注意事项?
  • GLT2抑制剂Farxiga(达格列净)治疗慢性肾脏病:显著降低肾功能恶化及死亡风险,无论疾病的根本原因如何
  • 利奥制药Enstilar泡沫剂长期治疗斑块型银屑病具有显著疗效和良好安全性!
  • 利伐沙班Xarelto中文说明书
  • Kadcyla (恩美曲妥珠单抗)辅助治疗HER2阳性早期乳腺癌在日获批!
  • 赛诺菲/再生元Dupixent达必妥(度普利尤单抗)降低儿童严重哮喘发作率65%
  • Xpovio(Selinexor)说明书-价格-功效与作用-副作用
  • Monjuvi(Tafasitamab-cxix)说明书-价格-功效与作用-副作用
  • 达沙替尼联合Blincyto(博纳吐单抗)一线治疗急性淋巴细胞白血病(ALL)总生存率高达95%!
  • ublituximab+umbralisib组合疗法获FDA快速通道资格,用于慢性淋巴细胞白血病(CLL)!
  • Opdivo联合Cabometyx用于晚期肾细胞癌获FDA优先审查,疗效优于Sutent
  • 强生重磅血癌药物Darzalex+VTd方案一线治疗多发性骨髓瘤(MM)疗效强劲!
  • 艾伯维Rinvoq在欧美提交新适应症申请,用于中重度特应性皮炎成人和青少年患者!
  • 乙肝新药TAF替诺福韦适用人群是哪些?需要注意什么?
  • 美国FDA加速批准新型ADC药物Padcev,用于治疗膀胱癌PD-(L)1抑制剂和化疗难治患者!
  • 美国FDA批准非霍奇金淋巴瘤新药Polivy上市!
  • Entocort EC布地奈德胶囊(Budesonide)获FDA批准,用于Crohn病
  • 乐伐替尼(Lenvima)用法用量及注意事项详解
  • 帕博西尼palbociclib联合芳香化酶抑制剂(letrozole)治疗乳腺癌安全性如何?


  • 如您发现本网站有文字编辑或内容错误,请点击此处发送(需要安装有foxmail或outlook支持),


    或发邮件至:info@morecare.hk,香港济民药业感谢您的到访!


    欢迎您添加香港济民药业微信,或在公众号内留言。

    香港济民微信公众号
    • 香港济民药业友情链接
    • 友情链接

    联系我们:

    地址:
    Rm. 314, Sun Ling Plaza, 30 On Kui Street, Fanling, HONG KONG
    邮箱:
    info@pidrug.com
    电话:
    198 9654 1773
    粤ICP备17150936号
    香港济民药业官方网站
    • 关注我们 :
    • 香港济民药业微博
    • 关注香港济民药业博客
    • 香港济民药业微信公众号