Side Effects of propranolol (cardiovascular): A Synthesis of Findings from 30 Studies

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Original Abstract of the Article

Major Research Findings

Propranolol is a medication widely used to treat cardiovascular diseases in children. However, several studies have shown that propranolol can cause various side effects in children. For example, 27 found that children admitted to the cardiovascular intensive care unit (CVICU) experienced side effects such as bradycardia, hypoglycemia, and initiation or escalation of inotropes after oral propranolol administration. Additionally, reported side effects such as bradycardia, hypoglycemia, and respiratory distress in infants receiving propranolol.

The side effects of propranolol can vary depending on factors such as age, dosage, and the patient's condition. To minimize these side effects, it is crucial to carefully evaluate the patient's condition before using propranolol and adjust the dosage appropriately. Regular monitoring of the patient's heart rate, blood pressure, and blood sugar levels is also essential during propranolol administration.

Reasons for Side Effects

Propranolol is known as a beta-blocker, which works by binding to beta receptors in the heart and blood vessels, reducing the heart's contractility and dilating blood vessels. This action can lead to a slower heart rate and lower blood pressure. Propranolol also has the effect of lowering blood sugar levels. These actions are thought to be the cause of propranolol's side effects.

Common Side Effects

Bradycardia

Propranolol can cause bradycardia because it slows down the heart rate. 27 found bradycardia in 27 (11%) children admitted to the CVICU. also reported bradycardia as a side effect of propranolol in infants.

Hypoglycemia

Propranolol can cause hypoglycemia because it lowers blood sugar levels. 27 found hypoglycemia in 46 (19%) children admitted to the CVICU. also reported hypoglycemia as a side effect of propranolol in infants. 5 reported severe hypoglycemia in infants treated with propranolol.

Respiratory Distress

reported respiratory distress as a side effect of propranolol in infants.

Gastrointestinal Symptoms

29 suggests that propranolol can cause gastrointestinal side effects.

Neuropsychiatric Symptoms

Propranolol can cause neuropsychiatric symptoms such as dizziness, headache, fatigue, insomnia, and depression. 16 reported hallucinations as a neuropsychiatric side effect in patients taking carvedilol, a beta-blocker similar in structure to propranolol.

Others

Other side effects of propranolol may include rash, itching, swelling, liver dysfunction, and kidney dysfunction.

Side Effect Management

Bradycardia

If bradycardia occurs due to propranolol, the dosage may need to be reduced or the medication discontinued. Pacemaker treatment may also be necessary.

Hypoglycemia

If hypoglycemia occurs due to propranolol, it is necessary to consume glucose. The dosage may need to be reduced or the medication discontinued. Special attention is required for patients with a history of diabetes.

Respiratory Distress

If respiratory distress occurs due to propranolol, the medication should be discontinued. Oxygen therapy may be necessary if needed.

Gastrointestinal Symptoms

If gastrointestinal symptoms occur due to propranolol, measures such as dietary therapy and drug therapy may be necessary. The dosage may need to be reduced or the medication discontinued.

Neuropsychiatric Symptoms

If neuropsychiatric symptoms occur due to propranolol, the medication should be discontinued. Consultation with a psychiatrist may be necessary if needed.

Others

If other side effects occur due to propranolol, consult with a doctor.

Comparison Between Studies

Commonalities

Multiple studies have shown that propranolol can cause side effects such as bradycardia and hypoglycemia in children. Moreover, the side effects of propranolol can vary depending on factors such as age, dosage, and the patient's condition.

Differences

Each study examined different types and frequencies of side effects, and the age groups studied were different, making it difficult to make direct comparisons. For example, 27 focused on children admitted to the cardiovascular intensive care unit (CVICU), while focused on infants.

Caution for Real-Life Applications

Propranolol is an effective medication for treating cardiovascular diseases in children, but the risk of side effects needs to be considered. It is important to consult with a doctor and adjust the dosage appropriately when using propranolol. Regular monitoring of the patient's heart rate, blood pressure, and blood sugar levels is also essential during propranolol administration. If you suspect any side effects from propranolol, consult with a doctor immediately.

Current Limitations in Research

Research on the side effects of propranolol is still insufficient. In particular, there are many unknown aspects regarding the long-term side effects of propranolol in children, and further research is needed.

Future Research Directions

Research on the side effects of propranolol should be conducted in the following directions.

  • Long-term side effect research on propranolol in children
  • Research on predictive factors for propranolol side effects
  • Research on measures to reduce propranolol side effects

Conclusion

Propranolol is an effective medication for treating cardiovascular diseases in children, but the risk of side effects such as bradycardia and hypoglycemia needs to be considered. It is important to consult with a doctor and adjust the dosage appropriately when using propranolol. Regular monitoring of the patient's heart rate, blood pressure, and blood sugar levels is also essential during propranolol administration. If you suspect any side effects from propranolol, consult with a doctor immediately.

Keywords
Benefit Keywords
Chemical warfare protection
1
JWH-018 antidote identification
2
Reduced hemorrhage
4
Tumor regression
5
Cardioprotective strategies
Cardiovascular research
7
BB choice
Drug adherence
8
HLH treatment
9
Reduced mortality
10
Akathisia treatment
Essential tremor treatment
Migraine treatment
11
Hemangioma treatment
14
Cardiovascular disease treatment
Carvedilol efficacy
16
Congenital JET treatment
17
IH treatment
18
IH treatment
20
Dysmenorrhea
Human reproduction
Tocolysis
21
Propranolol effective
Safe for hemangiomas
23
Rapid airway access
24
Infantile hemangioma treatment
Propranolol effectiveness
25
IH involution
26
Cardiovascular intensive care
27
Effective airway haemangioma treatment
Reduced side effects
28
Limit AAA expansion
Medical treatment for small AAA
29
Safe outpatient initiation
30
Risk Keywords
Side effects
1
JWH-018 intoxication
2
Elevated Troponin
Sinus Tachycardia
Subclinical Hyperthyroidism
3
Cardiovascular side effects
Hypoglycemia
Respiratory side effects
5
Hypoglycemia
Sinus bradycardia
6
Cardiotoxicity
7
BB side effects
8
Respiratory side effects
10
Depression risk
Neuropsychiatric side effects
11
Prolonged QT interval
TdP
12
Bradycardia
Cardiac arrest
Elevated aminotransferase levels
Granulopenia
Hemorrhagic complications
Hyponatremia
Hypotension
Intensified side effects of amlodipine
Myalgia
Peripheral thrombosis
Polyuria
Worsening of propafenone tolerance
13
Beta blockade side effects
14
Cardiovascular side effects
15
Abnormal thinking
Aggravated depression
Delirium
Emotional lability
Hallucinations
Impaired concentration
Nervousness
Paroniria
Psychosis
Sleep disorder
Somnolence
Vivid dreams
16
Cardiac side effects
17
Adverse events
20
Adverse effects
Preterm labor
21
Aneurysm
Coronary artery ectasia
Kawasaki disease
PSVT
Subdural effusion
22
Hypotension
23
Drug interactions
Hyperkalemia
24
Propranolol side effects
25
Complications
26
Bradycardia
Hypoglycemia
Inotrope escalation
27
Relapse
Treatment failure
28
Literature analysis of 30 papers
Positive Content
24
Neutral Content
0
Negative Content
6
Article Type
2
2
1
5
28
1.

Side effects of low-dose pyridostigmine bromide are not related to cholinesterase inhibition.

Author: CookM R, GerkovichM M, SastreA, GrahamC

Chemical warfare protection
Side effects

Pyridostigmine bromide (PB) is used to protect against chemical warfare attacks. This study aimed to determine the side effects of low-dose PB, including their type, intensity, and frequency. It also aimed to identify factors predicting the side effects' intensity and frequency.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.

Language : English

3.

Pre-workout Induced Demand Ischemia.

Author: Rodriguez GuerraMiguel A, Urena NemeAna P, ShabanMohammed, Matos NoboaConstangela, TrinhTiffany

Elevated Troponin
Sinus Tachycardia
Subclinical Hyperthyroidism

Pre-workout supplements may cause sinus tachycardia, elevated troponin, and subclinical hyperthyroidism. Proper hydration can help improve symptoms and troponin levels.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

4.

Safety and efficacy of propranolol for treatment of familial cerebral cavernous malformations (Treat_CCM): a randomised, open-label, blinded-endpoint, phase 2 pilot trial.

Author: LanfranconiSilvia, ScolaElisa, MeessenJennifer M T A, PalliniRoberto, BertaniGiulio A, Al-Shahi SalmanRustam, DejanaElisabetta, LatiniRoberto,

Reduced hemorrhage

This study investigates the safety and efficacy of prolonged propranolol treatment in reducing the risk of symptomatic intracerebral hemorrhage or focal neurological deficit in people with familial cerebral cavernous malformations, based on observations suggesting its potential benefit.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Safety assessment of propranolol for infantile hemangioma: a study in an Asian population.

Author: YuLu, WeiLi, XuZigang, ZhangBin, HanXiaofeng, SunYujuan, LiuYuanxiang, WangChen, QiuLei, XiuBingyu, HeRui, LiLi, MaLin

Hypoglycemia
Sinus bradycardia

Oral propranolol is a safe treatment for infantile hemangioma (IH). A retrospective analysis of 336 infants found no serious side effects, although some minor side effects, such as sinus bradycardia and hypoglycemia, were observed. The dose of propranolol did not affect its safety profile.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Contraindications Differ Widely Among Beta Blockers and Ought to be Cited for an Individual Drug, Not for the Entire Class.

Author: KoraćevićGoran, StojanovićMilovan, KostićTomislav, LovićDragan, ZdravkovićMarija, KoraćevićMaja, PavlovićDimitrije, MićićSlađana

BB choice
Drug adherence
BB side effects

Beta-blockers (BBs) are commonly prescribed medications, but their side effects can lead to poor adherence. This paper suggests an improved method of reporting contraindications for BBs by listing specific contraindications for individual BBs rather than the entire class. This approach could potentially improve drug adherence and patient outcomes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Cardiovascular Drug Therapy during Interstage After Hybrid Approach: A Single-Center Experience in 51 Newborns with Hypoplastic Left Heart.

Author: MienertTino, EsmaeiliAnoosh, SteinbrennerBlanka, KhalilMarkus, MüllerMatthias, AkintuerkHakan, KerstGunter, SchranzDietmar

HLH treatment

Newborns with hypoplastic left heart (HLH) often undergo the Norwood procedure or a hybrid stage I procedure. The hybrid approach is preferred. This study emphasizes the importance of drug therapy for managing the high-risk interstage between stage I and comprehensive stage II or advanced biventricular repair.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

10.

Beta-blocker therapy in patients with COPD: a systematic literature review and meta-analysis with multiple treatment comparison.

Author: GuleaClaudia, ZakeriRosita, AldermanVanessa, MorganAlexander, RossJack, QuintJennifer K

Reduced mortality
Respiratory side effects

Beta-blockers are associated with reduced mortality in patients with cardiovascular disease, but concerns about respiratory side effects have led to their underprescription in patients with COPD. This study investigated the effects of beta-blockers on outcomes in COPD patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

11.

Neuropsychiatric Consequences of Lipophilic Beta-Blockers.

Author: CojocariuSabina Alexandra, MaștaleruAlexandra, SascăuRadu Andy, StătescuCristian, MituFlorin, Leon-ConstantinMaria Magdalena

Akathisia treatment
Essential tremor treatment
Migraine treatment
Depression risk
Neuropsychiatric side effects

Beta-blockers can cross the blood-brain barrier and have both adverse and therapeutic effects in the neuropsychiatric field. They can cause neuropsychiatric side effects but are also effective in treating migraines, essential tremor, and akathisia.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

Propranolol exhibits activity against hemangiomas independent of beta blockade.

Author: SasakiMaiko, NorthPaula E, ElseyJustin, BubleyJeffrey, RaoShikha, JungYoonhee, WuShengnan, ZouMing-Hui, PollackBrian P, KumarJayanth, SinghHartej, ArbiserJack L

Hemangioma treatment
Beta blockade side effects

This study investigated the mechanism of action of propranolol in hemangioma of infancy and found that the inactive R-isomer of propranolol inhibits hemangioma growth without the side effects of beta blockade.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

Differential mechanisms of action of the trace amines octopamine, synephrine and tyramine on the porcine coronary and mesenteric artery.

Author: KohAndy Hsien Wei, Chess-WilliamsRuss, LohningAnna Elizabeth

Cardiovascular side effects

Trace amines such as p-tyramine, p-octopamine and p-synephrine can induce contractions in porcine isolated coronary and mesenteric arteries.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

16.

The Man Who Saw Things on Carvedilol.

Author: AikoyeSalisu A, JafferanyMohammad, OsuagwuVanessa, PlathDianne L

Cardiovascular disease treatment
Carvedilol efficacy
Abnormal thinking
Aggravated depression
Delirium
Emotional lability
Hallucinations
Impaired concentration
Nervousness
Paroniria
Psychosis
Sleep disorder
Somnolence
Vivid dreams

Carvedilol, a non-selective vasodilating beta blocker, is widely used in treating cardiovascular diseases. While its side effects are vast, hallucinations have rarely been reported.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

17.

Ivabradine is an effective antiarrhythmic therapy for congenital junctional ectopic tachycardia-induced cardiomyopathy during infancy: Case studies.

Author: ErgulYakup, OzturkErkut, OzgurSenem, OzyurtAbdullah, CilsalErman, GuzeltasAlper

Congenital JET treatment
Cardiac side effects

Junctional ectopic tachycardia (JET) is a rare arrhythmia commonly seen in infancy. This article presents three cases of infantile congenital JET treated with ivabradine, a new-generation antiarrhythmic, which rapidly converted the tachycardia into sinus rhythm without any significant side effects.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

Safety and effectiveness of oral propranolol for infantile hemangiomas started before 5 weeks and after 5 months of age: an Italian multicenter experience.

Author: El HachemMaya, GesualdoFrancesco, DiociaiutiAndrea, BertiIrene, VercellinoNadia, BoccalettiValeria, NeriIria, PorceddaGiulio, GrecoAntonella, CarnevaleClaudia, OrangesTeresa, CutroneMario, DalmontePietro

IH treatment

This study reviews the experience of 8 Italian pediatric and dermatologic centers regarding propranolol treatment for infantile hemangiomas (IH) in infants younger than 5 weeks or older than 5 months. Although propranolol is not licensed for these age groups, it is often used to prevent or treat severe complications associated with IH.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.

Language : English

20.

Topical Timolol Maleate Treatment of Infantile Hemangiomas.

Author: PüttgenKatherine, LuckyAnne, AdamsDenise, PopeElena, McCuaigCatherine, PowellJulie, FeigenbaumDana, SavvaYulia, BaselgaEulalia, HollandKristen, DroletBeth, SiegelDawn, MorelKimberly D, GarzonMaria C, MathesErin, LaurenChristine, NopperAmy, HoriiKimberly, NewellBrandon, SongWei, FriedenIlona,

IH treatment
Adverse events

This study retrospectively assessed the effectiveness and safety of topical timolol maleate for the treatment of infantile hemangioma in a pediatric population. The study aimed to evaluate timolol's effectiveness, identify characteristics associated with response, and document reported adverse events.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.

Language : English

21.

Beta-adrenoceptors in obstetrics and gynecology.

Author: ModzelewskaBeata

Dysmenorrhea
Human reproduction
Tocolysis
Adverse effects
Preterm labor

This review discusses the use of beta-blockers and beta-agonists in obstetrics and gynecology. Beta-blockers are used to treat disorders of the cardiovascular system and other dysfunctions that started before pregnancy. Beta-adrenoceptor agonists are the primary method for inhibiting premature uterine contractions.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

22.

A male infant had subdural effusion and paroxysmal supraventricular tachycardia during the febrile episode of Kawasaki disease: a case report and literature review.

Author: ChouChia-Pei, LinI-Chun, KuoKuang-Che

Aneurysm
Coronary artery ectasia
Kawasaki disease
PSVT
Subdural effusion

Paroxysmal supraventricular tachycardia is a severe but rare cardiovascular complication of Kawasaki disease, an inflammatory vasculitis that can affect the coronary arteries.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

23.

Is cardiovascular evaluation necessary prior to and during beta-blocker therapy for infantile hemangiomas?: A cohort study.

Author: RaphaelMartine F, BreugemCorstiaan C, VlasveldFlorine A E, de GraafMarlies, SliekerMartijn G, PasmansSuzanne G M A, BreurJohannes M P J

Propranolol effective
Safe for hemangiomas
Hypotension

Pretreatment electrocardiogram (ECG) was of limited value for patients with infantile hemangiomas (IH) who had a normal heart rate and blood pressure. Hypotension may occur during treatment, but no serious complications were reported in this retrospective study of 109 patients.

Evaluation StudyResearch that systematically evaluates the effectiveness of a particular program or policy. It measures its outcomes and provides important information for future decision-making.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

24.

Fatal hyperkalemia following succinylcholine administration in a child on oral propranolol.

Author: GanigaraAnuradha, RavishankarChandrakala, RamavakodaChandrika, NishtalaMadhavi

Rapid airway access
Drug interactions
Hyperkalemia

This case report highlights a fatal drug interaction between succinylcholine and propranolol, a nonselective β-adrenergic blocker. Both drugs can cause hyperkalemia, which, in susceptible individuals, can lead to life-threatening cardiac arrhythmias and asystole.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

26.

Low-dose propranolol regimen for infantile haemangioma.

Author: TanCherise Es, ItinteangTinte, LeadbitterPhilip, MarshReginald, TanSwee T

IH involution
Complications

This study reports on a stepwise escalation regimen for propranolol treatment of proliferating infantile haemangioma (IH). The aim was to determine the minimal dosage and duration of treatment needed to achieve accelerated involution while minimizing side effects.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Evaluation StudyResearch that systematically evaluates the effectiveness of a particular program or policy. It measures its outcomes and provides important information for future decision-making.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

28.

Propranolol is an effective treatment for airway haemangiomas: a critical analysis and meta-analysis of published interventional studies.

Author: VlastarakosP V, PapacharalampousG X, ChrysostomouM, TavoulariE-F, DelidisA, ProtopapasD, NikolopoulosT P

Effective airway haemangioma treatment
Reduced side effects
Relapse
Treatment failure

This meta-analysis reviewed the efficacy of propranolol in managing airway haemangiomas in children. Propranolol was found to be effective and outperformed previous gold standard treatments with fewer side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

29.

Medical treatment of small abdominal aortic aneurysm.

Author: AssarA N

Limit AAA expansion
Medical treatment for small AAA

This review examines medical treatment options for small abdominal aortic aneurysms (AAAs). While surgical repair is indicated for larger AAAs, medical treatment, such as doxycycline or roxithromycin, may help limit the expansion of smaller AAAs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

30.

Initial experience with a multidisciplinary strategy for initiation of propranolol therapy for infantile hemangiomas.

Author: CushingSharon L, BoucekRobert J, ManningScott C, SidburyRobert, PerkinsJonathan A

Safe outpatient initiation

Outpatient initiation of propranolol therapy for infantile hemangiomas was safely initiated in 39 of 44 patients (89%). Careful cardiovascular evaluation by an experienced clinician is essential for pretreatment evaluation, inpatient admission (when necessary), blood pressure and heart rate monitoring following initial dosing, and parent education.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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