Professional Documents
Culture Documents
TEAM 2 MEMBERS:
Stella O. Akpuaka
Bosede Adedire
Tamika Missouri
Amanda Rothenbecker
Antihypertensives
Thiazide
Diuretics
Beta Blockers
ACE Inhibitors
Calcium Channel blockers
Angiotensin II Receptor Blockers
Alpha 1 Blockers
Alpha2Agonists
Drug Name:
PROPRANOLOL:
generic
Inderal; Inderal Long acting (LA) - Brand name
Classification:
KEY
PHARMACODYNAMICS
PHARMACOKINETICS
Lipid soluble (lipophilic)
Excretion -------- Hepatic (Liver)
Absorptions rate --- 90%
Availability after first pass --- 30%
Peak time of concentration ------1-1.5hrs
Half life ------3-5 hrs; 8-11hrs for long acting
Duration of action -----11hrs
Protein bound --------93%
Hepatic Metabolism -------2D6 substrate
INDICATION/RECOMMENDED
DOSAGE
CONTRAINDICATION
bradycardia
Greater than first degree heart block
Cardiogenic shock
Pulmonary edema
Severe Asthma or COPD
Raynauds disease
Pregnancy (second and third trimesters)
Uncompensated heart failure
Hypersensitivity
B-BLOCKERS
PROPRANOLOL PRECAUTIONS
AVOID IN PATIENTS WITH ANAPHYLACTIC ALLERGIC
REACTIONS
MAY MASK SIGNS AND SYMPTOMS OF HYPOGLYCEMIA
CAUTIOUSLY USE IN PATIENTS WITH HEPATIC/ RENAL
IMPAIRMENT
CAUTIOUSLY USE IN PATIENTS WITH REACTIVE AIRWAY
REVIEW OF LITERATURE
IMPLEMENTATION PLAN
PRESCRIBING CONSIDERATIONS
IMPLEMENTATION PLAN
CULTURAL CONSIDERATIONS, AGE, ETHNICITY
IMPLEMENTATION PLAN
ADHERENCE
A telephone follow-up to Medicare patients, by
pharmacists, has shown to increase patient
adherence with home antihypertensive medications
(Barner, Gabrillo, Godly, & Moczygema, 2008)
Frequent dosing and increased cost decreases
adherence (Albert, 2008)
Patients are more likely to be adherent to a
regimen that is started during a hospital admission
because they relate the medication to the disease
(Albert, 2008)
Special Consideration
Pregnancy and Lactation: Category C Teratogenic and embryo toxic effects have been demonstrated in
animals. Give drugs only if the potential benefit justifies the potential
risk to the fetus.
The AAC/AHA update recommend that all patient with cardiac disease
be seen by a cardiologist before initiating a beta blocker.
Beta blocker therapy should be used in all patient with left ventricular
systolic dysfunction ( ejection fraction <40%), with heart failure
or prior myocardial infarction unless contraindicated.
Allow one to two months for a drug trial with beta blockers to adjust
dose and monitor for therapeutic response and adverse reactions.
REFERENCES