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JAMA Jul 1977Classic features of thyrotoxicosis developed in three patients with no prior history of thyroid disease shortly after the discontinuation of therapy with or decrease in...
Classic features of thyrotoxicosis developed in three patients with no prior history of thyroid disease shortly after the discontinuation of therapy with or decrease in doseage of propranolol hydrochloride. Graves' disease probably developed fortuitously after propranolol therapy was instituted, but the beta-adrenergic blockade masked the clinical features of hyperthyroidism. On discontinuation of propranolol therapy or decrease in propranolol dosage, previously latent thyrotoxicosis became manifest. If hyperthyroidism masked by beta-blockade is not recognized before withdrawal of propranolol therapy in patients with ischemic heart disease, the sudden appearance of thyrotoxicosis may lead to symptoms of increased myocardial ischemia.
Topics: Adult; Female; Humans; Hyperthyroidism; Male; Middle Aged; Propranolol; Substance Withdrawal Syndrome; Thyroid Hormones
PubMed: 577524
DOI: No ID Found -
Clinical Pharmacology and Therapeutics Jan 1989The relative contributions of the debrisoquin and mephenytoin isozymes of hepatic cytochrome P-450 to the stereoselective metabolism of propranolol have been studied in...
The relative contributions of the debrisoquin and mephenytoin isozymes of hepatic cytochrome P-450 to the stereoselective metabolism of propranolol have been studied in a panel of volunteers of known oxidative phenotypes. Six subjects were extensive metabolizers of both debrisoquin and mephenytoin (EM). Four subjects were poor metabolizers of debrisoquin but rapid for mephenytoin (PMD). Five subjects were poor metabolizers of mephenytoin but rapid for debrisoquin (PMM), and one individual had a deficiency for both test compounds (PMD/M). Partial metabolic clearances of each propranolol enantiomer to 4-hydroxypropranolol (4-OH-P), the sulfate, and glucuronide conjugates of 4-OH-P, naphthoxylactic acid (NLA) and propranolol glucuronide, were estimated after a single oral dose of racemic propranolol (80 mg). The partial metabolic clearance of both enantiomers to total 4-OH-P in the PMD group was 75% less than in the EM and PMM groups, indicating the contribution of the debrisoquin isozyme to this route of metabolism. The R/S ratios for the clearance to 4-OH-P were similar between EM and PMD (2.5 +/- 0.5 vs 2.5 +/- 0.4, respectively), implying that the different enzymes involved in ring hydroxylation (i.e., the debrisoquin isozyme and other hydroxylases) have similar stereoselective preferences. The partial metabolic clearance to NLA was 55% less in the PMM group than in the EM and PMD groups, indicating that S-mephenytoin 4-hydroxylase contributes to the metabolic conversion of propranolol to NLA. The R/S ratios for the clearance to NLA were close to unity in all groups. The partial metabolic clearance to propranolol glucuronide also did not exhibit stereoselectivity and was similar in all groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Aryl Hydrocarbon Hydroxylases; Cytochrome P-450 CYP2C19; Cytochrome P-450 CYP2D6; Cytochrome P-450 Enzyme System; Humans; Hydroxylation; Metabolic Clearance Rate; Mixed Function Oxygenases; Polymorphism, Genetic; Propranolol; Stereoisomerism
PubMed: 2910639
DOI: 10.1038/clpt.1989.11 -
American Heart Journal Jun 1972
Topics: Blood Pressure; Diuretics; Female; Humans; Hypertension; Male; Middle Aged; Propranolol; Retrospective Studies
PubMed: 5053145
DOI: 10.1016/0002-8703(72)90206-2 -
Circulation Aug 1978
Topics: Blood Platelets; Humans; Platelet Aggregation; Propranolol; Substance Withdrawal Syndrome
PubMed: 668066
DOI: 10.1161/01.cir.58.2.202 -
Carcinogenesis May 1995Nitrosation of propranolol, a beta-adrenergic blocking drug previously found to react with nitrite in HCl solution yielding a genotoxic nitrosamine, was examined under...
Nitrosation of propranolol, a beta-adrenergic blocking drug previously found to react with nitrite in HCl solution yielding a genotoxic nitrosamine, was examined under simulated gastric conditions. In the presence of a low concentration of nitrite (2.9 mM) and a therapeutic gastric concentration of the drug (5.4 mM), the yield of N-nitrosopropranolol was higher in simulated gastric juice, which contained both pepsin and thiocyanate, than in distilled water, and at pH 3.5 than at pH 1.0. A 55 microM concentration of N-nitrosopropranolol was reached after 180 min. It is reasonable to assume that the extremely small amounts of N-nitrosopropranolol formed in the human stomach should not represent a significant carcinogenic risk, but co-formulation of propranolol with ascorbic acid, which has been found to minimize the nitrosation reaction, might be useful to avoid a further, even if minimal, contribution to the already existing exposure to genotoxic chemicals.
Topics: Gastric Juice; Humans; Hydrochloric Acid; Hydrogen-Ion Concentration; Kinetics; Nitrites; Nitrosamines; Pepsin A; Propranolol; Thiocyanates
PubMed: 7767991
DOI: 10.1093/carcin/16.5.1239 -
Journal of Psychiatry & Neuroscience :... 2022
Meta-Analysis
Topics: Emotions; Humans; Memory Consolidation; Propranolol
PubMed: 36130812
DOI: 10.1503/jpn.220072-l -
Archives of Internal Medicine Feb 1979
Topics: Clonidine; Drug Interactions; Humans; Hypertension; Male; Middle Aged; Propranolol
PubMed: 434988
DOI: 10.1001/archinte.139.2.253 -
Progress in Neuro-psychopharmacology 1980
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Propranolol; Psychiatric Status Rating Scales; Schizophrenia; Stereoisomerism
PubMed: 7220678
DOI: 10.1016/0364-7722(81)90106-5 -
The American Journal of Cardiology Aug 1973
Topics: Female; Humans; Lactation; Milk, Human; Pregnancy; Pregnancy Complications, Cardiovascular; Propranolol; Tachycardia, Paroxysmal
PubMed: 4721124
DOI: No ID Found -
The Medical Letter on Drugs and... Sep 1979
Clinical Trial
Topics: Clinical Trials as Topic; Drug Administration Schedule; Humans; Migraine Disorders; Propranolol
PubMed: 381886
DOI: No ID Found