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Latest Drugs
Pain Management Drug Data - A-Z (English)
Drug Class Description
Non-cardioselective b-blockers (beta-blockers).Generic Name
Propranolol - migraineDrug Description
Beta-Prograne: white sustained- release capsules. Half Beta-Prograne: clear/white sustained-release capsules.Presentation
Beta-Prograne: Propranolol hydrochloride 160 mg . Half Beta-Prograne: Propranolol hydrochloride 80 mg .Indications
Migraine prophylaxis.
Adult Dosage
80 mg or 160 mg daily; maximum 240 mg daily.Child Dosage
Not recommended.Contra Indications
2nd or 3rd degree AV block, sinus bradycardia, sick sinus syndrome, severe peripheral arterial disease, uncompensated cardiac failure, cardiogenic shock, hypotension, right ventricular failure secondary to pulmonary hypertension, significant cardiomegaly, untreated phaeochromocytoma. Non- cardioselective beta-blockers are also generally contraindicated in patients with obstructive airways disease or a history of bronchospasm.Special Precautions
Poor cardiac reserve should be controlled with digitalis and diuretics. Diabetes; metabolic acidosis. Asthenic symptoms. Cerebrovascular insufficiency. Renal or hepatic impairment, thyrotoxic crisis. General anaesthesia; consider withdrawal before elective surgery. Pregnancy, lactation. Withdraw gradually.
Interactions
Clonidine withdrawal, verapamil, diltiazem, class II antiarrhythmics, cardiac depressant anaesthetics, hypoglycaemics, reserpine, other antihypertensives, ergot alkaloids, cimetidine, rifampicin, theophylline, warfarin, CNS depressants, sympathomimetics, indometacin (indomethacin).Adverse Reactions
Cold extremities, sleep disturbances (particularly with the more lipophilic drugs), bradycardia, exertional tiredness, bronchospasm, heart failure, hypotension, GI upset. If unexplained dry eyes or skin rash occur withdraw gradually.Manufacturer
TillomedDrug Availability
(POM)Updated
24 June 2009Advert for Healthcare Professionals Only
Related News
EU Commission approves Dexdor for sedation of patients in Intensive Care Pain Management Page
European Commission has granted Dexdor (dexmedetomidine) from Orion, centralised approval covering 27 European Union countries for sedation of adult intensive care unit patients requiring a level of sedation not deeper than arousal in response to verbal stimulation. The company plans to begin a European launch in Germany and Austria in early 2012. It will launch much later in other European countries. The drug is marketed outside the EU as Precedex by Hospira under licence from Orion.
Exparel is FDA approved for Post Surgical Analgesia Pain Management Page
Exparel(bupivacaine extended-release liposome injection),a non-opioid local analgesic, is FDA approved for post-surgical analgesia. Exparel provides analgesia for several days with a single intraoperative infiltration. The approval is based on a trial that showed a larger percentage of patients treated with Exparel avoided opioid rescue medication during the first 24 hours after surgery compared to placebo,,7% versus 1%. Exparel combines bupivacaine with DepoFoam drug delivery technology from Pacira Pharma.
Lexapro/Cipralex (Forest Labs/Lundbeck) reduces Pain in opiod-dependent patients Pain Management Page
Opioid-dependent patients treated with Lexapro/Cipralex (escitalopram), from Forest Labs and Lundbeck, experience meaningful reductions in pain severity and pain interference during the first three months of therapy, according to a study published in Pain. Among methadone-treated patients, estimates of chronic pain prevalence range between 37-61 percent. Management of pain in opioid-dependent patients is a clinical challenge given concerns for opioid abuse and misuse among individuals with prior substance use disorders. Yet unresolved pain may be a risk factor for relapse among patients whose pain is not fully treated. The study, led by Judith Tsui, MD, MPH, assistant professor of medicine at Boston University School of Medicine, evaluated the effects of Lexapro/Cipralex on treatment retention in patients with depressive symptoms who were initiating buprenorphine/naloxone for treatment of opioid dependence. Participants were randomized to receive 10 m.g. of Lexapro/Cipralex or a placebo daily. Changes in pain severity, pain interference and depression were assessed at one, two and three-month visits with the visual analog scale, Brief Pain Inventory, and the Beck Depression Inventory II, respectively. Treatment resulted in significantly decreased pain severity and interference over time, with a nearly 30 percent reduction in pain severity after one month compared to control. The study suggested that the analgesic properties of Lexapro/Cipralex were independent of its antidepressant effects. (See: Pain, Volume 152, Issue 11, Pages 2447-2672)
