Document Detail

The interaction between propranolol and epinephrine as observed in patients undergoing Mohs' surgery.
MedLine Citation:
PMID:  3722513     Owner:  NLM     Status:  MEDLINE    
The blood pressure response to the administration of epinephrine-containing local anesthetics was studied prospectively in ten patients taking propranolol and in ten control patients. While no significant alteration in blood pressure was documented for the patients taking propranolol, the blood pressures of the control group tended to decrease following injection of anesthetic. The variation in blood pressure response between the two groups was statistically significant and represents a mild manifestation of the blockade of beta-2 receptors of the vascular beds from the propranolol. The uncommon occurrence of a malignant hypertensive response from a propranolol-epinephrine reaction is probably a dose-related, somewhat idiosyncratic sensitivity of the peripheral vasculature to the alpha pressor effect of epinephrine unmasked by the blockade of beta receptors. The risk of this catastrophic event must be weighed against the risk of precipitating a myocardial ischemic event from too rapid an alteration in propranolol dosage. Malignant hypertension is probably uncommon in patients receiving low doses of epinephrine during most dermatologic procedures.
L M Dzubow
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American Academy of Dermatology     Volume:  15     ISSN:  0190-9622     ISO Abbreviation:  J. Am. Acad. Dermatol.     Publication Date:  1986 Jul 
Date Detail:
Created Date:  1986-08-21     Completed Date:  1986-08-21     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7907132     Medline TA:  J Am Acad Dermatol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  71-5     Citation Subset:  IM    
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MeSH Terms
Analysis of Variance
Blood Pressure / drug effects*
Drug Interactions
Epinephrine / pharmacology*
Propranolol / pharmacology*
Prospective Studies
Skin Neoplasms / surgery
Reg. No./Substance:
51-43-4/Epinephrine; 525-66-6/Propranolol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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