Propanolol

completely absorbed

maximum plasma levels occurs 1-3 hours after ingestion

>90% of drug is bound to plasma proteins in the blood

first pass metabolism: drug is metabolized at liver resulting in reduced systemic concentrations

main metaoblite hydroxypropanolol is 5.2 to 7.5
hours

metabolites are excreted in urine

blocks action of epinephrine and norepinephrine at Beta 1 and 2 adrenergic receptors

sodium-channel blocking and prevents action potential propagation down an axon

is lipid soluble and crosses blood-brain barrier

influence antisympathetic activity in CNS

anti-hypertensive drug

nonselective Beta blocker

prevent strokes/myocardial infarction/cardiac arrythmias

reduce heart rate

reduce cardiac stroke volume

reduced sympathetic activity

reduce release of renin from juxtaglomerular apparatus

chronic propanolol therapy and lidocaine with epinephrine administration is associated with hypertensive blood pressure

monitor patient's vital signs throughout appointment and minimize any stressful activities that could elevate hypertensive patient's vitals

used to reduce patient anxiety before extractions or post extractions to minimize dental-related apprehension. This practice has not been studied

Subtopic

xerostomia --> increased caries risk

altered/loss sense of taste

oral lichenoid reaction

80mg orally 1x/day

hypertension

coronary heart disease

arrythmia

angina pectoris

smoking

COPD

bradycardia

Atrioventricular Valve block

shock syndrome

severe low blood pressure

NSAIDS may reduce effectivness of drug

Blood thinning drugs

blood pressure drugs: ACE inhibitors, other beta blockers, or alpha blockers

anesthesia with epinephrine

abrupt withdrawal is associated with tachycardia, angina pectoris, and rarely myocardial infarction

dizziness

tiredness

diarrhea

constipation

difficulty breathing

rash/swelling/hives/itching

overdose side effect: slow heartbeat