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    While once a first-line treatment for hypertension, the role for beta blockers was downgraded in June 2006 in the United Kingdom to fourth-line, as they do not perform as well as other drugs, particularly in the elderly, and evidence is increasing that the most frequently used beta blockers at usual doses carry an unacceptable risk of provoking type 2 diabetes. Propranolol is not recommended for the treatment of hypertension by the Eighth Joint National Committee (JNC 8) because a higher rate of the primary composite outcome of cardiovascular death, myocardial infarction, or stroke compared to an angiotensin receptor blocker was noted in one study. Propranolol works to inhibit the actions of norepinephrine, a neurotransmitter that enhances memory consolidation. In one small study individuals given propranolol immediately after trauma experienced fewer stress-related symptoms and lower rates of PTSD than respective control groups who did not receive the drug. Due to the fact that memories and their emotional content are reconsolidated in the hours after they are recalled/re-experienced, propranolol can also diminish the emotional impact of already formed memories; for this reason, it is also being studied in the treatment of specific phobias, such as arachnophobia, dental fear, and social phobia. Ethical and legal questions have been raised surrounding the use of propranolol-based medications for use as a "memory damper", including: altering memory-recalled evidence during an investigation, modifying behavioral response to past (albeit traumatic) experiences, the regulation of these drugs, and others. However, Hall and Carter have argued that many such objections are "based on wildly exaggerated and unrealistic scenarios that ignore the limited action of propranolol in affecting memory, underplay the debilitating impact that PTSD has on those who suffer from it, and fail to acknowledge the extent to which drugs like alcohol are already used for this purpose." Propranolol may be used to treat severe infantile hemangiomas (IHs). metoprolol medicine It comes in these forms: oral tablet, oral extended-release capsule, oral solution, and injectable. Propranolol oral tablet is only available in a generic form. Generic drugs usually cost less than brand-name versions. Propranolol oral tablet may be used in combination with other drugs. Propranolol reduces your heart’s workload and helps it beat more regularly. It’s used to: Propranolol belongs to a class of drugs called beta blockers. A class of drugs is a group of medications that work in a similar way.

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    Increase at 3- to 7-day intervals to maximum daily dose of 640 mg. W or normal saline solution infused slowly, not to exceed 1 mg/minute. Depresses myocardial contractility or AV conduction. Treat bradycardia with atropine (0.25 to 1 mg); if no response, administer isoproterenol cautiously. daily in two to four divided doses or sustained-release form once daily. Use cautiously in elderly patients; in patients with impaired renal or hepatic function, nonallergic bronchospastic diseases, diabetes mellitus, or thyrotoxicosis; and in those receiving other antihypertensives. After acute ingestion, induce emesis or empty stomach by gastric lavage; follow with activated charcoal to reduce absorption, and administer symptomatic and supportive care. After 3 mg have been infused, another dose may be given in 2 minutes; subsequent doses no sooner than q 4 hours. Treat cardiac failure with cardiac glycosides and diuretics and hypotension with glucagon or vasopressors; epinephrine is preferred. Contraindicated in patients with bronchial asthma, sinus bradycardia and heart block greater than first-degree, cardiogenic shock, and heart failure (unless failure is secondary to a tachyarrhythmia that can be treated with propranolol). use of a beta blocker and verapamil has resulted in serious adverse reactions, especially in patients with severe cardiomyopathy, heart failure, or recent MI. May reduce blood pressure by blocking adrenergic receptors (thus decreasing cardiac output), by decreasing sympathetic outflow from the CNS, and by suppressing renin release. Treat bronchospasm with isoproterenol and aminophylline. Beta-blockers affect the heart and circulation (blood flow through arteries and veins). Propranolol is used to treat tremors, angina (chest pain), hypertension (high blood pressure), heart rhythm disorders, and other heart or circulatory conditions. It is also used to treat or prevent heart attack, and to reduce the severity and frequency of migraine headaches. Hemangeol (propranolol oral liquid 4.28 milligrams) is given to infants who are at least 5 weeks old to treat a genetic condition called infantile hemangiomas. Hemangiomas are caused by blood vessels grouping together in an abnormal way. These blood vessels form benign (non-cancerous) growths that can develop into ulcers or red marks on the skin. Hemangiomas can also cause more serious complications inside the body (in the liver, brain, or digestive system).

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