Propranolol-Epinephrine Antagonism with Hypertension and Stroke
Authors: JOHN F. HANSBROUGH
Journal: Annals of Internal Medicine (1980)

Letters and Corrections1 May 1980Propranolol-Epinephrine Antagonism with Hypertension and StrokeJOHN F. HANSBROUGH, M.D., ALIDA NEAR, M.D.JOHN F. HANSBROUGH, M.D.Search for more papers by this author, ALIDA NEAR, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-92-5-717_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptWe wish to call attention to a potentially dangerous adverse reaction to epinephrine used in combination with propranolol: paradoxical hypertension, which in our case below probably resulted in stroke. When cardiovascular homeostasis is impaired by beta-blocking agents, potentially serious reactions to adrenergic agents may result.A 57-year-old white woman was seen in the emergency room with the complaint of "hives." Current medications included propranolol, 60 mg/d (10 mg every 4 hours), prescribed for many years for "palpitations." She had no history of hypertension.At examination, she was in no distress. Her blood pressure was 120/70 mm Hg and her pulse,...References1. MORRELLI H: Propranolol. Ann Intern Med. 1973;78:913-7. LinkGoogle Scholar2. INNESNICKERSON IM. Norepinephrine, epinephrine, and the sympathomimetic amines. In: GOODMAN LS, GILMAN A, eds. The Pharmacological Basis of Therapeutics. New York: Macmillan, 1975:483-4. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: University of Colorado School of Medicine Denver, CO 80262 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByBasic and Clinical Pharmacology of Autonomic DrugsMedical Management of GlaucomaGeriatrics, Pediatrics, and the Gravid WomanEFFECT OF β-ADRENORECEPTOR BLOCKADE WITH NADOLOLADVERSE DRUG INTERACTIONS IN DENTAL PRACTICE: INTERACTIONS ASSOCIATED WITH VASOCONSTRICTORSAn unusual toxic reaction to axillary block by mepivacaine with adrenalineMedical issues and emergencies in the dermatology officeAdverse effects of epinephrine when given to patients taking propranolol (Inderal)Contraindications to vasoconstrictors in dentistry: Part IIIClinical implications of autonomic drugsDrug InteractionsEpinephrine-containing test dose during beta-blockadeSystemic drug interactions with topical glaucoma medicationsThe cardioselectivity of beta adrenoceptor antagonistsSevere epinephrine-propanolol interactionβ-Adrenoceptor antagonists and antianginal drugsHypertensive response to levonordefrin in a patient receiving propranolol: report of casePropranolol, Epinephrine, and Accelerated Hypertension During HemodialysisTHOMAS V. WHELAN, M.D.Vasoconstrictors and Local Anesthesia: A Review and Rationale for UseCentral nervous system stimulants and anorectic agents 1 May 1980Volume 92, Issue 5Page: 717-717KeywordsAdverse reactionsBlood pressureEmergency departmentEpinephrineHeart rateHypertensionStrokeUrticaria Issue Published: 1 May 1980 PDF DownloadLoading ...