Propranolol
Class II
| IV Dose | 0.02 mg/kg every 5 min to 0.1 mg/kg total dose. |
| Oral dose | 2 mg/kg/day divided q 6 hours to start. Increase routinely to 5 mg/kg/day. May in rare circumstances go to 14 mg/kg/day, watching levels. Inderal LA should be given BID in children |
| Levels | 25-150 nanograms/ml for beta blockade. 150-1000 ng/ml for control of VT. |
| Kinetics | Large first-pass metabolism in liver. Elimination half-life 4-6 hours. (T 1/2 of 4-hydroxy-P 5.2-7.5 hours, active). Peak levels at 2-3 hours after oral dose. |
| Cautions | Contraindicated in asthma, congestive heart failure. Beware hypoglycemia in infants and diabetics |
| Interactions | Levels increased by cimetidine. Contraindicated with verapamil, due to synergistic negative inotropic effect and cardiovascular collapse Increases hepatic lidocaine metabolism. |
| Preparations | Inderal scored tabs: 10, 20, 40, 60, 80, 90 mg. Inderal LA capsules: 60, 80, 120, 160 mg. Inderal injection, 1 mg/1 ml ampules |
| FDA approval in children | yes |