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Inderal LA

What are calcium channel blockers (CCBs) and how do they work?

Calcium channel blockers are drugs that block the entry of calcium into the muscle cells of the heart and arteries.

  • The entry of calcium is critical for the conduction of the electrical signal that passes from muscle cell to muscle cell of the heart, and signals the cells to contract.
  • It also is necessary in order for the muscle cells to contract and thereby pump blood.
  • In the arteries, the entry of calcium into muscle cells causes contraction of the cells and thereby dilates (widens) the arteries.
  • Thus, by blocking the entry of calcium, calcium channel blockers reduce electrical conduction within the heart, decrease the force of contraction (work) of the muscle cells, and dilate arteries.
  • Dilation of the arteries reduces blood pressure and thereby the effort the heart must exert to pump blood.
  • Combined with decr...

Inderal LA

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OVERDOSE

Propranolol is not significantly dialyzable. In the event of overdosage or exaggerated response, the following measures should be employed:

General: If ingestion is or may have been recent, evacuate gastric contents, taking care to prevent pulmonary aspiration.

Supportive Therapy: Hypotension and bradycardia have been reported following propranolol overdose and should be treated appropriately. Glucagon can exert potent inotropic and chronotropic effects and may be particularly useful for the treatment of hypotension or depressed myocardial function after a propranolol overdose. Glucagon should be administered as 50-150 meg/kg intravenously followed by continuous drip of 1-5 mg/hour for positive chronotropic effect. Isoproterenol, dopamine or phosphodiesterase inhibitors may also be useful. Epinephrine, however, may provoke uncontrolled hypertension. Bradycardia can be treated with atropine or isoproterenol. Serious bradycardia may require temporary cardiac pacing.

The electrocardiogram, pulse, blood pressure, neurobehavioral status and intake and output balance must be monitored. Isoproterenol and aminophylline may be used for bronchospasm.

CONTRAINDICATIONS

Propranolol is contraindicated in 1) cardiogenic shock; 2) sinus bradycardia and greater than first-degree block; 3) bronchial asthma; and 4) in patients with known hypersensitivity to propranolol hydrochloride.

Last reviewed on RxList: 10/12/2010
This monograph has been modified to include the generic and brand name in many instances.

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