Investigation of the Safe Withdrawal Period for Propranolol in Patients Scheduled for Open Heart Surgery

Overview

Journal Br Heart J

Specialty Cardiology & Vascular Diseases

Date 1975 Dec 1

PMID 1225337

Citations 3

Authors

D J Coltart

M N CAYEN

E B Stinson

R H Goldman

R O Davies

D C Harrison

Affiliations

Soon will be listed here.

Abstract

The time necessary for dissipation of radioactive labelled propranolol and its metabolites and the cardiac effects of this agent in the hearts of patients undergoing open-heart surgery were studied. Isoprenaline produced chronotropic and inotropic responses in atrial muscle in tissue bath studies which were normal 8 to 12 hours after withdrawing propranolol. After the administration of either 25 or 75 muCi of 14C-labelled propranolol, the myocardial tissue concentration declined to insignificant levels between 24 and 28 hours. We conclude that withdrawal of propranolol therapy 24 to 48 hours before cardiac surgery should be acceptable.

Citing Articles

Adaptational responses to prolonged beta-adrenoceptor blockade in adult rabbits.

Raine A, VAUGHAN WILLIAMS E Br J Pharmacol. 1980; 70(2):205-18.

PMID: 6107134 PMC: 2044330. DOI: 10.1111/j.1476-5381.1980.tb07926.x.

Antiarrhythmic drugs: clinical pharmacology and therapeutic uses.

Anderson J, Harrison D, Meffin P, Winkle R Drugs. 1978; 15(4):271-309.

PMID: 648399 DOI: 10.2165/00003495-197815040-00003.

Predictors of operative mortality for coronary bypass grafting in patients with ischemic heart disease.

Langou R, Wiles J, Peduzzi P, Hammond G, Cohen L Yale J Biol Med. 1978; 51(1):27-36.

PMID: 307873 PMC: 2595643.

References

Coltart D, Spilker B . Development of human foetal inotropic responses to catecholamines. Experientia. 1972; 28(5):525-6. DOI: 10.1007/BF01931857. View

SHAND D, Nuckolls E, OATES J . Plasma propranolol levels in adults with observations in four children. Clin Pharmacol Ther. 1970; 11(1):112-20. DOI: 10.1002/cpt1970111112. View

Alderman E, Coltart D, Wettach G, Harrison D . Coronary artery syndromes after sudden propranolol withdrawal. Ann Intern Med. 1974; 81(5):625-7. DOI: 10.7326/0003-4819-81-5-625. View

Fitzgerald J, ODonnell S . Pharmacology of 4-hydroxypropranolol, a metabolite of propranolol. Br J Pharmacol. 1971; 43(1):222-35. PMC: 1665931. DOI: 10.1111/j.1476-5381.1971.tb07171.x. View

Faulkner S, Hopkins J, BOERTH R, Young Jr J, Jellett L, Nies A . Time required for complete recovery from chronic propranolol therapy. N Engl J Med. 1973; 289(12):607-9. DOI: 10.1056/NEJM197309202891204. View

Hayes A, Cooper R . Studies on the absorption, distribution and excretion of propranolol in rat, dog and monkey. J Pharmacol Exp Ther. 1971; 176(2):302-11. View

SHAND D, Rangno R . The disposition of propranolol. I. Elimination during oral absorption in man. Pharmacology. 1972; 7(3):159-68. DOI: 10.1159/000136285. View

Viljoen J, Estafanous F, Kellner G . Propranolol and cardiac surgery. J Thorac Cardiovasc Surg. 1972; 64(5):826-30. View

WEISSLER A, Harris W, SCHOENFELD C . Systolic time intervals in heart failure in man. Circulation. 1968; 37(2):149-59. DOI: 10.1161/01.cir.37.2.149. View

10.

SLOME R . Withdrawal of propranolol and myocardial infarction. Lancet. 1973; 1(7795):156. DOI: 10.1016/s0140-6736(73)90235-3. View

11.

Coltart D, SHAND D . Plasma propranolol levels in the quaniitative assessment of beta-adrenergic blockade in man. Br Med J. 1970; 3(5725):731-4. PMC: 1701661. DOI: 10.1136/bmj.3.5725.731. View

12.

Cleaveland C, Rangno R, SHAND D . A standardized isoproterenol sensitivity test. The effects of sinus arrhythmia, atropine, and propranolol. Arch Intern Med. 1972; 130(1):47-52. DOI: 10.1001/archinte.130.1.47. View