Propranolol
| Drug monograph · NCLEX study reference | |
| Trade names | Inderal |
|---|---|
| Therapeutic class | Antihypertensive, antianginal, antiarrhythmic, antimigraine, antitremor |
| Pharmacologic class | Nonselective beta blocker |
| Onset / peak / duration | PO onset 1 to 2 hours; IV within minutes; ER lasts 24 hours. |
| Half-life / level | Half-life 3 to 6 hours; no routine level. |
| Routes | PO (oral) |
| High-alert (ISMP) | No |
| Black box warning | None |
| Antidote / reversal | Atropine, glucagon for refractory overdose. |
| Pregnancy / lactation | Use only if clearly needed. |
Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.
Propranolol (brand name Inderal) — Antihypertensive, antianginal, antiarrhythmic, antimigraine, antitremor; Nonselective beta blocker.
Identification
- Therapeutic class: Antihypertensive, antianginal, antiarrhythmic, antimigraine, antitremor.
- Pharmacologic class: Nonselective beta blocker.
Pharmacology
- Mechanism of action: Blocks beta-1 and beta-2 receptors; crosses into the central nervous system, useful for tremor and migraine prevention.
- Onset / peak / duration: PO onset 1 to 2 hours; IV within minutes; ER lasts 24 hours.
- Half-life / therapeutic level: Half-life 3 to 6 hours; no routine level.
Clinical use
- Indications: Hypertension, angina, arrhythmias, migraine prophylaxis, essential tremor, performance anxiety, hyperthyroid symptoms.
- Usual dose, route, frequency: 40 to 160 mg PO daily in divided doses or ER once daily.
- Maximum dose / adjustments: Varies widely by indication; reduce in hepatic impairment.
Safety
- Contraindications: Asthma and bronchospastic disease, severe bradycardia, heart block, decompensated heart failure.
- Black box warning: No formal box; warning against abrupt discontinuation.
- Interactions: Calcium channel blockers, other antihypertensives, insulin (masks hypoglycemia), CYP substrates.
- Pregnancy / lactation: Use only if clearly needed.
- High-alert: No.
Adverse effects
- Common side effects: Bradycardia, fatigue, dizziness, cold extremities.
- Serious effects to report: Bronchospasm, symptomatic bradycardia, heart block, masked hypoglycemia.
- Antidote / reversal: Atropine, glucagon for refractory overdose.
Nursing process
- Assessment before administration: Heart rate, blood pressure, respiratory history.
- Interventions during therapy: Avoid in asthma; hold for bradycardia; taper to stop.
- Monitor: Heart rate, blood pressure, glucose in diabetics.
- Evaluation / expected outcome: Indication-specific control (blood pressure, tremor, migraine frequency).
Patient teaching
- Patient teaching: Beta blockers can blunt the racing-heart warning sign of low blood sugar.
- Notify provider if: Wheezing, very slow heartbeat, fainting.
- Administration tips: Consistent timing; do not stop abruptly.