Propranolol interaction

Another example is the determination of the interaction of D-propranolol with LUVs of DMPC by FT-IR and quasielastic light scattering (QLS) [62]. The results of the two complementary techniques showed that cationic D-propranolol interacts with DMPC. The FT-IR spectra indicate that the drug is localized at the aqueous interface of the bilayer. Figure 3.15 shows the temperature dependence of the wavenumber of the symmetric CH2 stretching mode of DMPC LUV in the absence and presence of... 

Ochs HR, Greenblatt DJ, Verburg-Ochs B. Propranolol interactions with diazepam, lorazepam, and alprazolam. Clin Pharmacol Ther 1984 36(4) 451-5. 

Propranolol interacts with /3j and receptors with equal affinity, lacks intrinsic sympathomimetic activity, and does not block a receptors. 

A study in 6 healthy subjects receiving 30-hour infusions of lidocaine at a rate of 2 mg/minute found that pretreatment with propranolol 80 mg every 8 hours for 3 days raised the steady-state plasma lidocaine levels by 19% (from 2.1 to 2.5 micrograms/mL) and reduced the plasma clearance by 16%. Other similar studies have found a 22.5 to 30% increase in steady-state serum lidocaine levels and a 14.7 to 46% fall in plasma clearance due to the concurrent use of propranolol. Two cases of lidocaine toxicity attributed to a lidocaine-propranolol interaction were revealed by a search of the FDA adverse drug reaction file in 1981. A further case of lidocaine toxicity (seizures) has been described in a man on propranolol after accidental oral ingestion of lidocaine for oesophageal anaesthesia. High serum levels of lidocaine were detected. ... 

The lidocaine/propranolol interaction is established and of clinical importance. Monitor the effects of concurrent use and reduce the intravenous lidocaine dosage if necessary to avoid toxicity. The situation with other... 

Graham CF, Turner WM, Jones JK. Lidocaine-propranolol interactions. NEnglJMed(1981) 304,1301. 

Adverse Drug Reactions Advisory Committee. Chlormediiazole/propranolol interaction MedJAust (1979) 2,553. 

Gancfy W. Severe epinephrine-propranolol interaction AnnEmergMed( 9 ) 18,98-9. 

Use of zileuton is uncommon due to the need for dosing four times a day, potential drug interactions, and the potential for hepatotoxicity with the resulting need for frequent monitoring of liver enzymes. In patients started on zileuton, serum alanine aminotransferase concentrations should be monitored before treatment begins, monthly for the first 3 months, every 2 to 3 months for the remainder of the first year, and then periodically thereafter for as long as the patient continues to receive the medication. Zileuton also inhibits the cytochrome P-450 (CYP) mixed function enzyme system and has been shown to decrease the clearance of theophylline, R-warfarin and propranolol.34... 

The P-blockers propranolol and timolol are FDA-approved for migraine prophylaxis, but other drugs in the class are also as effective.46 Cautious dosage titration is advised for those patients who do not have other indications for P-blocker use. Rizatriptan interacts with propranolol and thus dosages must be titrated downward, or another triptan chosen for abortive therapy.36 Comorbid reactive airway disease is a relative contraindication to P-blocker prophylaxis, and patients with cardiac conduction disturbances should be closely monitored. Calcium channel antagonists are often used when patients cannot tolerate P-blockers. They are purported to beneficially... 

Kramer, S. D. Braun, A. Jakits-Dieser, C. Wunderli-Allenspach, H., Towards the predictability of drug-lipid membrane interactions The pH-dependent affinity of propranolol to phosphatidyliniositol containing liposomes, Pharm. Rev. 15, 739-744 (1998). 

Figure 8 Localization of solute (propranolol) within the lipid bilayer. This solute-membrane interaction has been shown to influence the conformation and activity of a calcium-pump protein (X) embedded in the bilayer. (From Ref. 78.)... 

L Herbette, AM Katz, JM Sturtevant. Comparisons of the interaction of propranolol and timolol with model biological membrane systems. Molec Pharmacol 24 259-269, 1983. 

Fig. 20.13. Potential H-bonding energy, released upon interaction with the transmembrane domains of P-gp (in arbitrary energy units, EU) for progesterone (1), propranolol (2), amitriptyline (3), diltiazem (4), amiodarone (5), colchicine (7), gramicidin S (8), daunorubicin (9), vinblastine (10), cyclosporin A, in comparison with verapamil...

The studies on phospholipid bilayers with defined amounts of charged component are helpful to explain the partition characteristics in biological membranes. Liposome water partition data of propranolol in lipids from kidney epithelial cells (a common model system in pharmaceutical sciences for the uptake into the gastrointestinal tract) have been successfully described with partition models developed for pure bilayers or defined mixtures [159]. Since lipophilic cations and anions can be used as probes for the membrane potential, their interaction with microbial and mitochondrial membranes has been studied... 

Herbette et al. compared the sorption site of the structurally similar tertiary amines propranolol and timolol [164]. Propranolol has a naphthalene substituent on the aliphatic chain, which is deeply incorporated into the hydrophobic core of the membrane. In contrast, timolol carries a partially charged morphine ring at the same place. This substituent, due to its polarity and partial charge, does not interact favourably with the membrane interior. Consequently, the AnW at pH 7.5 is 20 times higher for propranolol than for timolol, and timolol has less influence on the phase transition. 

Saha N, Datta H, Sharma PL. (1991). Effects of morphine on memory interactions with naloxone, propranolol, and haloperidol. Pharmacology. 42(1) 10-14. 

FIGURE IS Electrochromatograms obtained for the separation of basic drugs spiked in a human serum compared with a blank in a hydrophobic interaction CEC. Column 5 pm 300 A polysulfoethyl A particles, 20 cm packed length, 50 pm ID mobile phase ACN/TEAP buffer (80 20) applied voltage, 10 kV detection at 214 nm. Drugs (I) amobarbital (2) phenobarbital (3) barbital (4) caffeine (5) sulfanilamide (6) theophylline (7) 2,4-dimethylquinoline (8) propranolol. (Reproduced with permission from reference 76.)... 

Drug/Lab test interactions These agents may produce hypoglycemia and interfere with glucose or insulin tolerance tests. Propranolol and betaxolol may interfere with the glaucoma screening test due to a reduction in intraocular pressure. 

Drug/Food interactions Food enhances the bioavailability of metoprolol and propranolol this effect is not noted with nadolol, bisoprolol, or pindolol. The rate of carteolol and penbutolol absorption is slowed by the presence of food however, extent of absorption is not appreciably affected. Sotalol absorption is reduced approximately 20% by a standard meal. 

Drugs that may interact with hydralazine include beta blockers (eg, metoprolol, propranolol) and indomethacin. 

Schematic principle of ACE interaction between a hydroxypropylated CD and propranolol.

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