Propranolol
James L. Schardein, Orest T. Macina in Human Developmental Toxicants, 2006
Propranolol is a ß-blocking drug with therapeutic utility as an antianginal and antiarrhythmic agent and an antihypertensive and antimigraine agent. Nonselective ß-adrenergic blocking drugs, numbering about 15 including propranolol, competitively block response to ß- and ß-adrenergic stimulation, which results in decreases in heart rate, myocardial contractility, blood pressure, and myocardial oxygen demand. In animal studies, propranolol had little adverse developmental effect. Authors of published studies on the developmental effects in humans caused by propranolol reported few adverse findings. A solitary study reported a case of tracheoesophageal fistula and intrauterine growth retardation in an infant whose mother was treated with 80 mg/day of the drug throughout the first trimester. Propranolol is a hydrophobic molecule with average size in comparison to the other human developmental toxicants. It can participate in hydrogen bonding, both as acceptor and donor.
Endocrine disorders
Janet M Rennie, Giles S Kendall in A Manual of Neonatal Intensive Care, 2013
The most common cause of ambiguous genitalia is congenital adrenal hyperplasia (CAH), causing masculinization of baby girls. Parathyroid disorders are exceptionally rare in the neonatal period but the diagnosis becomes a possibility if the other, much more common, causes of hyper-or hypocalcaemia have been excluded. Babies treated with steroids for conditions such as chronic lung disease are at risk of developing classic steroid side effects, including reduced growth, hypertension and hyperglycaemia. The incidence of congenital hypothyroidism is about 1:3500 and is due to either thyroid dysgenesis/agenesis or goitrous cretinism. In mild cases, symptomatic treatment with propranolol 2 mg/kg/24 h may be sufficient as the condition is transient. Any male infant who suddenly collapses with vomiting, pallor or hypotension in the first 10 days of life should be suspected of having CAH, especially if his nipples, scrotum or penis appear to be too pigmented.
Cardiovascular Drugs during Pregnancy
“Bert” Bertis Britt Little in Drugs and Pregnancy, 2022
Heart disease occurs among about 1 percent of pregnant women. Pregnant women with heart disease present several medical dilemmas. Pharmacokinetic changes during pregnancy affect cardiovascular drug disposition. Cardiovascular medications may be classified into six categories: antiarrhythmic, cardiac glycosides, anticoagulants, diuretics, antihypertensives, and antianginals. In pregnancy, amiodarone is used to treat life-threatening ventricular arrhythmias that did not respond to first-line medications, and should not be used long term except when other regimens fail. Atenolol is a beta-blocker used to treat arrhythmias. It has been associated with fetal hypoglycemia. Mexiletine is a local anesthetic similar to lidocaine in action. Also like lidocaine, it is an antiarrhythmic agent. Primary use of mexiletine is to treat ventricular arrhythmias. Propaferone is an oral antiarrhythmic used to treat ventricular tachycardia. The most extensively studied beta-blocker during pregnancy is propranolol. It is used to treat supraventricular and ventricular tachycardia, hypertension, hyperthyroidism, migraine headaches, and panic attacks.
Use of Propranolol for Infantile Hemangiomas
Published in Pediatric Hematology and Oncology, 2012
Treating infantile hemangiomas may be associated with significant morbidity. Recently, propranolol, a nonselective β-blocker, has become a reputed and successful treatment modality for infantile hemangiomas. Here, the author presents experience with oral propranolol in treatment of 14 patients with infantile hemangiomas. The drug was tolerated well and no side effects except reversible bronchospasm in 3 were observed during treatment. Eleven of the patients, younger than 1 year, showed a good response, with more than 50% reduction in the size of the hemangiomas. Although there are a limited number of patients, these results showed that oral propranolol therapy is a safe and effective choice in the treatment of infantile hemangiomas before the age of 1 year.
The combined effect of furosemide and propranolol on GSH homeostasis in ACHN renal cells
Published in Toxicology Mechanisms and Methods, 2014
Fatemeh Zal, Raheleh Taheri, Fatemeh Khademi, Ehsan Keshavarz, Sadegh Rajabi, Zohreh Mostafavi-Pour
Objectives: Propranolol, a beta-adrenergic blocker, is used in the treatment of a large number of cardiovascular diseases such as hypertension and arrhythmias. Propranolol, in combination with furosemide, is used to treat hypertensive disorders although their side effect profile is not very obvious. In present study, the effects of the drugs furosemide and propranolol were in corporately investigated both on glutathione homeostasis and their antioxidant effect on ACHN cells. Methods: The cytoxicities and antioxidant effects of these two clinically important drugs on human kidney cell lines were evaluated using MTT following by the determination of glutathione reductase (GR) and glutathione peroxidase (GPx) activities and measuring the level of reduced glutathione (GSH). Results: Propranolol induced a significant cytotoxic effect at 100 µM, while furosemide was cytotoxic at doses of 250 and 1000 µg/ml. A slight increase in GPx and GR activities and GSH level was observed with propranolol and furosemide treatment alone, while the two drugs together caused a significant increase in GPx and GR activities (35% and 42%, respectively) and GSH content (35%) in ACHN cell lysates (p
Mechanisms of propranolol action in infantile hemangioma
Published in Dermato-Endocrinology, 2014
Infantile hemangioma is a common tumor of infancy. Although most hemangiomas spontaneously regress, treatment is indicated based on complications, risk to organ development and function, and disfigurement. The serendipitous discovery of propranolol, a non-selective β-adrenergic receptor blocker, as an effective means to regress hemangiomas has made this a first-line therapy for hemangioma patients. Propranolol has shown remarkable response rates. There are, however, some adverse effects, which include changes in sleep, acrocyanosis, hypotension, and hypoglycemia. Over the last few years, researchers have focused on understanding the mechanisms by which propranolol causes hemangioma regression. This has entailed study of cultured vascular endothelial cells including endothelial cells isolated from hemangioma patients. In this article, we review recent studies offering potential mechanisms of how various cell types found in hemangioma may respond to propranolol.
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