Clinical Uses

Propranolol is indicated in the management of a variety of cardiac rhythm abnormalities that are totally or partially due to enhanced adrenergic stimulation. In selected cases of sinus tachycardia caused by anxiety, pheochromocytoma, or thyrotoxicosis, p-blockade will reduce the spontaneous heart rate.

Propranolol alone or in conjunction with digitalis can help control the ventricular rate in patients with atrial flutter or atrial fibrillation. Patients with supraventricular extrasystoles and intermittent paroxysms of atrial fibrillation may benefit from p-receptor blockade with propranolol.

The arrhythmias associated with halothane or cyclopropane anesthesia have been attributed to the interaction of the anesthetic with catecholamines, and they have been suppressed by IV administration of 1 to 3 mg propranolol. An increase in circulating catecholamines also has been observed in patients with acute myo-cardial infarction and has been correlated with the development of arrhythmias.

Clinically, tachyarrhythmias associated with digitalis excess (including supraventricular and ventricular extrasystoles) and ventricular tachycardia have been suppressed by propranolol. Although propranolol is highly effective in the treatment of digitalis-induced arrhythmias, phenytoin and lidocaine are preferred.

Long-term treatment with p-adrenoceptor blocking agents is clearly associated with an increased rate of

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