Propranolol is contraindicated for patients with depressed myocardial function and may be contraindicated in the presence of digitalis toxicity because of the possibility of producing complete A-V block and ventricular asystole. Patients receiving anesthetic agents that tend to depress myocardial contractility (ether, halothane) should not receive propranolol. Propranolol should be used with extreme caution in patients with asthma.
Up-regulation of p-receptors follows long-term therapy, making abrupt withdrawal of p-blockers dangerous for patients with ischemic heart disease.
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