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Cardiovascular Drugs
Published in Radhwan Nidal Al-Zidan, Drugs in Pregnancy, 2020
Risk Summary: Nadolol is not a teratogen; however, its use during the 2nd and 3rd Trimesters is discouraged because its administration, during this period, has been linked with the incidence of reduced placental weight and IUGR.
Genetically Determined Ventricular Arrhythmias
Published in Andrea Natale, Oussama M. Wazni, Kalyanam Shivkumar, Francis E. Marchlinski, Handbook of Cardiac Electrophysiology, 2020
Houman Khakpour, Jason S. Bradfield
Among symptomatic patients, nadolol and propranolol performed better than metoprolol. The risk of cardiac events was 3.9-fold greater when patients were treated with metoprolol.29 However, in another recent large retrospective study assessing the efficacy of the 4 most commonly prescribed β-blockers (atenolol, metoprolol, nadolol, and propranolol) in 1530 patients, all β-blockers were equally effective in reducing the risk of a first cardiac event. In the subcohort of patients with LQT1 (n = 379), no β-blocker was superior, whereas in LQT2 (n = 406), nadolol was slightly more effective than other β-blockers. In patients with at least one cardiac event while taking β-blockers, propranolol appeared to be the least effective drug.30 The data from the retrospective studies clearly underline the beneficial effect of β-blocker therapy in LQTS but caution should be exercised before drawing conclusions about their relative efficacy. There is agreement that nadolol is probably one of the more effective drugs for this condition.31 Abrupt discontinuation of beta-blockers should be avoided.
Drug therapy for portal hypertension
Published in Michael JG Farthing, Anne B Ballinger, Drug Therapy for Gastrointestinal and Liver Diseases, 2019
Propranolol and nadolol are given orally with doses adjusted for each patient according to clinical tolerance, heart rate and arterial blood pressure. In general, the dose is increased every 2–3 days until the heart rate decreases by 25%, but not below 55 beats/min, while maintaining a systolic blood pressure above 80 mmHg. Once the maintenance dose is reached, it is possible to give the total dose in a single administration of a long-acting preparation.
Pregnancy in women with congenital heart disease: a focus on management and preventing the risk of complications
Published in Expert Review of Cardiovascular Therapy, 2023
Gurleen Wander, Johanna A. van der Zande, Roshni R Patel, Mark R Johnson, Jolien Roos-Hesselink
The risk of VTE is highest during the postpartum period and prophylaxis with LMWH and compression stockings is recommended. Breastfeeding is encouraged in women with CHD although there is a small increased risk of bacteremia secondary to mastitis. However, in the context of HF, breast feeding is discouraged as it may put additional strain on the heart. Drugs like metoprolol, nadolol (beta blockers), enalapril, captopril (ACE Inhibitors), amlodipine (and most calcium channel blockers), furosemide and warfarin are considered safe during breastfeeding. Women with complex CHD should be followed jointly by their cardiologist and obstetrician, 6–12 weeks post-delivery [71,72].
Pharmacotherapy in inherited and acquired ventricular arrhythmia in structurally normal adult hearts
Published in Expert Opinion on Pharmacotherapy, 2019
Staniel Ortmans, Charline Daval, Martin Aguilar, Pablo Compagno, Julia Cadrin-Tourigny, Katia Dyrda, Lena Rivard, Rafik Tadros
Beta-blockers are the cornerstone of CPVT management and are indicated in all patients. Hayashi et al. published in 2009 the results of a large cohort of 101 CPVT patients. During a mean follow-up of 7.9 years, β-blockers were associated with a reduction in cardiac events (syncope/ACA/SCD) from 25% to 11% (p = 0.05) [60]. The specific beta-blocker to use is somewhat controversial. Nadolol (1–2 mg/kg twice a day) may show higher efficacy [61] and is our preferred drug. Propranolol is a reasonable alternative if nadolol is not available.
The ketogenic diet and the QT interval
Published in Baylor University Medical Center Proceedings, 2020
Sivakumar Sudhakaran, Laila Yazdani, Kevin R. Wheelan, Praveen K. Rao
The patient was started on nadolol 40 mg daily. She remained arrhythmia free for 48 hours after hospital admission and was discharged with plans for close outpatient follow-up. She was told to stop the ketogenic diet and resume a normal diet. At discharge, she was continued on nadolol 40 mg daily. She was seen in clinic approximately 1 month later. Device interrogation revealed no arrhythmic events, and ECG showed her QTc to be 424 ms. She was continued on nadolol 40 mg daily and had no fibrillation events in the next 6 months.