PROPRANOLOL, compr.

Nume: PROPRANOLOL, compr.

Tip: propranololum

Producator: Sintofarm S.A.

Indicatii: Angina de piept, ?ndeosebi angina cronica stabila (ca tratament de fond) si pentru profilaxia pe termen lung dupa perioada acuta a infarctului miocardic; aritmii cardiace supraventriculare si unele tahiaritmii digitalice; cardiomiopatie obstructiva; hipertensiune arteriala esentiala, mai ales forme cu circulatie hiperkinetica si debit cardiac crescut, forme cu hiperreninemie sau asociat hipopresolului si nefrixului; profilaxia migrenelor; tireotoxicoza; ?naintea si ?n timpul interventiilor chirurgicale pentru feocromocitom (se asociaza obligatoriu un blocant -adrenergic, de exemplu tolazolina); stari anxioase (mai ales c?nd predomina tulburarile cardiace), tremor esential; pentru profilaxia hemoragiilor digestive la cirotici (cu exceptia insuficientei hepatice severe, cu icter, ascita mare, encefalopatie).

Contraindicatii: Insuficienta cardiaca necontrolata, soc cardiogen, bloc atrio-ventricular (fara pacemaker electronic), fenomene Raynaud, bradicardie marcata (sub 55/minut), astm bronsic, bronsita spastica, hipoglicemie, acidoza metabolica (de exemplu la diabetici), prudenta sau se evita ?n timpul sarcinii si alaptarii. Propranololul poate creste periculos efectul deprimant circulator al anestezicelor generale (se ?ntrerupe cu 48 de ore ?nainte de interventiile chirurgicale sau, daca nu este posibil, se injecteaza 1-2 mg atropina ca medicatie anestezica); nu se asociaza cu verapamil si cu orice medicament care deprima miocardul (chinidina, procainamida, lidocaina); mascheaza simptomele vegetative ale hipoglicemiei provocate de insulina sau sulfamide antidiabetice (risc de supradozare); efectul hipotensiv al propranololului este crescut de guanetidina, reserpina si diuretice; stimularea -adrenergica (prin noradrenalina, adrenalina etc.), sub propranolol poate provoca vasoconstrictie periculoasa; toate aceste asocieri medicamentoase impun prudenta; propranololul ?mpiedica efectele izoprenalinei (bronhodilatin) si altor stimulente -adrenergice. Propranololul (?n administrare sistemica) figureaza pe lista substantelor dopante (este interzis la sportivi).

Precautii:

Reactii: Greata, voma, diaree sau constipatie, senzatie de rece ?n extremitati, sudoratie, insomnie, cosmaruri, oboseala, stare depresiva, cefalee, fotofobie, interferarea functiei sexuale (diminuarea capacitatii de reactie); rareori purpura, dispnee, halucinatii vizuale, parestezii. Agraveaza insuficienta cardiaca, favorizeaza blocul atrioventricular, poate provoca bronhospasm, agraveaza tulburarile circulatorii periferice; administrarea ?ndelungata poate determina modificari nefavorabile ale lipidelor plasmatice (cresterea colesterolului, LDL si a trigliceridelor). ?ntreruperea brusca a tratamentului prelungit poate provoca, mai ales la bolnavii cu angina pectorala severa care au raspuns bine la -blocante, agravarea anginei, infarct de miocard, aritmii ventriculare (doza de propranolol trebuie redusa treptat). ?n caz de hemoragie digestiva riscul prabusirii circulatorii poate fi crescut.

Compozitie: Comprimate contin?nd clorhidrat de propranolol 10 mg sau 40 mg.

Actiune: Blocant -adrenergic, cu actiune chinidinica slaba; nu are actiune simpatomimetica intrinseca, nu este cardioselectiv. Antiangios si antiaritmic prin blocare -adrenergica; ?nlatura influentele cardiostimulatoare simpatice si catecolaminice si diminueaza raspunsul inimii la efort, micsoreaza consumul de oxigen al miocardului, suprima focarele de automatism ectopic si procesul de reintrare, protejeaza fata de aritmii, ischemia miocardica si infarct; deprima forta de contractie a inimii si scade debitul cardiac, ?nt?rzie conducerea atrioventriculara (efectul deprimant miocardic are si o componenta chinidinica). Antihipertensiv prin diminuarea debitului cardiac, inhibarea secretiei de renina si prin actiune centrala.

Administrare: ?n angina pectorala si hipertensiunea arteriala se ?ncepe cu 40 mg de 2 ori/zi si se creste progresiv, dupa nevoie - doza obisnuita este de 80 mg (2 comprimate a 40 mg) de 2 ori/zi, uneori sunt necesare doze mai mari (320 mg/zi); pentru tratamentul de durata al infarctului (dupa 5-20 zile de la episodul acut) se administreaza 2-3 zile c?te 40 mg de 4 ori /zi, apoi 80 mg de 2 ori/zi; ?n aritmii, hipertiroidism, migrene, tremor, 10-40 mg de 2-3 ori/zi; pentru prevenirea recidivelor hemoragiei digestive la cirotici se ?ncepe cu 20 mg de 2 ori/zi, cresc?nd doza cu prudenta, dupa nevoie; pentru controlul dozei se urmareste pulsul, care nu trebuie sa scada sub 60/minut ?n repaus.

Vizualizari: 1871

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