Hypoglycemia In Children Taking Propranolol For The Treatment Of Infantile Hemangioma
Hypoglycemia in Children Taking Propranolol for the Treatment of Infantile Hemangioma Copyright 2010 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2010 Arch Dermatol. 2010;146(7):775-778. doi:10.1001/archdermatol.2010.158 Background Propranolol hydrochloride has been prescribed for decades in the pediatric population for a variety of disorders, but its effectiveness in the treatment of infantile hemangiomas (IHs) was only recently discovered. Since then, the use of propranolol for IHs has exploded because it is viewed as a safer alternative to traditional therapy. Observations We report the cases of 3 patients who developed symptomatic hypoglycemia during treatment with propranolol for their IHs and review the literature to identify other reports of propranolol-associated hypoglycemia in children to highlight this rare adverse effect. Conclusions Although propranolol has a long history of safe and effective use in infants and children, understanding and recognition of deleterious adverse effects is critical for physicians and caregivers. This is especially important when new medical indications evolve as physicians who may not be as familiar with propranolol and its adverse effects begin to recommend it as therapy. Propranolol hydrochloride, a nonselective -adrenergic blocking agent, has been used for years in infants and children with congenital heart disease, arrhythmias, hypertension, thryotoxicosis, migraines, and behavioral disorders. It has recently been used in the treatment of infantile hemangiomas (IHs) after growth arrest of an infant's hemangioma was incidentally noted when propranolol was started for obstructive hypertrophic myocardiopathy. 1 Given the lack of evidence-based standards for treat Continue reading >>
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Diabetes Update: Beta Blockers Worsen Blood Sugar--may Cause Diabetes
Beta Blockers Worsen Blood Sugar--May Cause Diabetes Many people know that it is a bad idea for anyone who takes insulin or a sulfonylurea drug to take a beta blocker. This is because it has long been known that these drugs block the counter-regulatory response that prevents a dangerous hypo or--if it cannot prevent the hypo--at least gives the victim some warning that one is coming by causing shakes and pounding pulse. Now evidence from a huge study of almost 20,000 people has learned that beta blockers are dangerous to anyone with any blood sugar abnormality. The study is Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA,). It was published in Diabetes Care in May. Determinants of new-onset diabetes among 19,257 hypertensive patients randomized in the Anglo-Scandinavian Cardiac Outcomes Trial--Blood Pressure Lowering Arm and the relative influence of antihypertensive medication. It concluded: "Baseline FPG >5 mmol/l, BMI, and use of an atenolol +/- diuretic regimen were among the major determinants of NOD [Non-insulin dependent diabetes i.e. Type 2] in hypertensive patients." An analysis of the study (which is still only available as an abstract to non-subscribers) published in Irish Medical News explains "Hypertensive patients allocated to amlodipine and perindopril were found 34% less likely to develop NOD [Type 2] compared with those allocated to the -blocker/diuretic combination." Diabetes in Control adds the following: "Says Dr Anoop Misra, director and head (diabetes and metabolic diseases) Fortis Hospitals: "In patients with hypertension, beta blocker drugs are no longer frontline therapy. These drugs may not only increase blood sugar levels in those who don't have diabetes, but may worsen sugar control in those with diabetes an Continue reading >>
Drugs That Can Worsen Diabetes Control
One of the main goals of any diabetes control regimen is keeping blood glucose levels in the near-normal range. The cornerstones of most plans to achieve that goal include following a healthy diet, getting regular exercise, and taking insulin or other medicines as necessary. However, it’s not uncommon for people with diabetes to have other medical conditions that also require taking medicines, and sometimes these drugs can interfere with efforts to control blood glucose. A few medicines, including some commonly prescribed to treat high blood pressure and heart disease, have even been implicated as the cause of some cases of diabetes. This article lists some of the medicines that can worsen blood glucose control, the reasons they have that effect, the usual magnitude of the blood glucose changes, as well as the pros and cons of using these drugs in people who have diabetes. Where the problems occur To understand how various medicines can worsen blood glucose control, it helps to understand how insulin, the hormone responsible for lowering blood glucose, works in the body. Insulin is released from the beta cells of the pancreas in response to rising levels of glucose in the bloodstream, rising levels of a hormone called GLP-1 (which is released from the intestines in response to glucose), and signals from the nerve connections to the pancreas. The secretion of insulin occurs in two phases: a rapid first phase and a delayed second phase. Both of these phases are dependent on levels of potassium and calcium in the pancreas. Insulin acts on three major organs: the liver, the muscles, and fat tissue. In the liver, insulin enhances the uptake of glucose and prevents the liver from forming new glucose, which it normally does to maintain fasting glucose levels. In muscle and f Continue reading >>
What Medicines Can Make Your Blood Sugar Spike?
If you have diabetes or high blood sugar, you probably know some of the things that cause your glucose (another name for blood sugar) to go up. Like a meal with too many carbohydrates, or not enough exercise. But other medicines you might take to keep yourself healthy can cause a spike, too. Know Your Meds Medicines you get with a prescription and some that you buy over the counter (OTC) can be a problem for people who need to control their blood sugar. Prescription medicines that can raise your glucose include: Steroids (also called corticosteroids). They treat diseases caused by inflammation, like rheumatoid arthritis, lupus, and allergies. Common steroids include hydrocortisone and prednisone. But steroid creams (for a rash) or inhalers (for asthma) aren’t a problem. Drugs that treat high blood pressure, such as beta-blockers and thiazide diuretics High doses of asthma medicines, or drugs that you inject for asthma treatment OTC medicines that can raise your blood sugar include: Cough syrup. Ask your doctor if you should take regular or sugar-free. How Do You Decide What to Take? Even though these medicines can raise your blood sugar, it doesn’t mean that you shouldn’t take them if you need them. The most important thing is to work with your doctor on the right way to use them. If you have diabetes or you’re watching your blood sugar, ask your doctor before you take new medicines or change any medicines, even if it’s just something for a cough or cold. (Remember, just being sick can raise your blood sugar.) Make sure your doctor knows all the medicines you take -- for diabetes or any other reason. If one of them may affect your blood sugar, she may prescribe a lower dose or tell you to take the medicine for a shorter time. You may need to check your blood s Continue reading >>
Beta Blocker Drug Therapy
Beta blockers block the effect of adrenaline (the hormone norepinephrine) on the body's beta receptors. This slows down the nerve impulses that travel through the heart. As a result, the resting heart rate is lower, the heart does not have to work as hard and the heart requires less blood and oxygen. Beta blockers can also block the impulses that can cause an arrhythmia (irregular heartbeat). This type of drug is generally prescribed for: If these medications are prescribed, the doctor should be made aware of any other drug, vitamin, mineral or herbal supplement the patient is taking, especially: Drugs for treating asthma , chronic bronchitis and emphysema Insulin and other medicines used to treat diabetes Medicines for high blood pressure, which may increase the effect of beta blockers The doctor should be told if the patient has: A slow heart rate (bradycardia) or heart block Allergies to foods or dyes, which can be made worse by beta blockers Asthma, which beta blockers can make worse Diabetes or hypoglycemia because beta blockers can cause the blood sugar levels to rise or hide the symptoms of low blood sugar Heart disease or poor circulation in the hands or feet Symptoms of hay fever, chronic bronchitis or emphysema Patients should avoid foods and beverages that have caffeine, antacids that have aluminum or over-the-counter cough and cold medications and antihistamines. Alcohol should also be avoided because it can decrease the effects of the beta blockers. To learn more about these types of drugs and their side effects, click on the links below: Continue reading >>
390 Drugs That Can Affect Blood Glucose Levels
Knowing the drugs that can affect blood glucose levels is essential in properly caring for your diabetes patients. Some medicines raise blood sugar in patients while others might lower their levels. However, not all drugs affect patients the same way. 390 Drugs that Can Affect Blood Glucose Levels is also available for purchase in ebook format. 390 Drugs that can affect blood glucose Level Table of Contents: Drugs that May Cause Hyper- or Hypoglycemia Drugs That May Cause Hyperglycemia (High Blood Sugar) (GENERIC NAME | BRAND NAME) Abacavir | (Ziagen®) Abacavir + lamivudine,zidovudine | (Trizivir®) Abacavir + dolutegravir + lamivudine | (Triumeq®) Abiraterone | (Zytiga®) Acetazolamide | (Diamox®) Acitretin | (Soriatane®) Aletinib | (Alecensa®) Albuterol | (Ventolin®, Proventil®) Albuterol + ipratropium | (Combivent®) Aliskiren + amlodipine + hydrochlorothiazide | (Amturnide®) Aliskiren + amlodipine | (Tekamlo®) Ammonium chloride Amphotericin B | (Amphocin®, Fungizone®) Amphotericin B lipid formulations IV | (Abelcet®) Amprenavir | (Agenerase®) Anidulafungin | (Eraxis®) Aripiprazole | (Abilify®) Arsenic trioxide | (Trisenox®) Asparaginase | (Elspar®, Erwinaze®) Atazanavir | (Reyataz ®) Atazanavir + cobistat | (Evotaz®) Atenolol + chlorthalidone | (Tenoretic®) Atorvastatin | (Lipitor®) Atovaquone | (Mepron®) Baclofen | (Lioresal®) Belatacept | (Nulojix®) Benazepril + hydrochlorothiazide | (Lotension®) Drugs That May Cause Hyperglycemia (High Blood Sugar) – Continued (GENERIC NAME | BRAND NAME) Betamethasone topical | (Alphatrex®, Betatrex®, Beta-Val®, Diprolene®, Diprolene® AF, Diprolene® Lotion, Luxiq®, Maxivate®) Betamethasone +clotrimazole | (Lotrisone® topical) Betaxolol Betoptic® eyedrops, | (Kerlone® oral) Bexarotene | (Targ Continue reading >>
Influence Of Beta-blocking Drugs On Glucose Metabolism In Hypertensive, Non-diabetic Patients.
Influence of beta-blocking drugs on glucose metabolism in hypertensive, non-diabetic patients. Groop L , Ttterman KJ , Harno K , Gordin A . Two beta-blocking agents, non-selective propranolol and beta 1-selective metoprolol, were investigated with respect to their effect on glucose metabolism in 11 hypertensive, non-diabetic patients. They were randomly treated for two weeks in a double-blind cross-over manner with propranolol, metoprolol and placebo. Both drugs caused a small but significant increase in basal blood glucose values as compared with placebo (p less than 0.01). Metoprolol increased the blood glucose concentrations during the first 10 min of an i.v. glucose tolerance test (IVGTT) as compared with placebo (p less than 0.02) and propranolol (p less than 0.05). Propranolol raised only the blood glucose values during the later part of the IVGTT (p less than 0.01). The increase in blood glucose concentrations was, however, not associated with significant changes in peripheral insulin levels. The mean basal glucagon concentrations were lower during propranolol and metoprolol than during placebo (p less than 0.01). Propranolol also induced a more pronounced reduction of plasma glucagon than placebo (p less than 0.05) at 10 min of the IVGTT. The mean basal free fatty acid (FFA) concentrations were lower during propranolol (p less than 0.001) and metoprolol (p less than 0.05) than during placebo. Both drugs decreased the plasma levels of FFA during the first 10 min of the IVGTT as compared with placebo (p less than 0.01 and p less than 0.02, respectively). Pharmacological doses of propranolol and metoprolol increased blood glucose concentrations, decreased plasma glucagon and FFA concentrations, but had no effect on serum insulin levels in hypertensive, non-diabeti Continue reading >>
Long-term Side Effects Of Propranolol
Noreen Kassem is a hospital doctor and a medical writer. Her articles have been featured in "Women's Health," "Nutrition News," "Check Up" and "Alive Magazine." Kassem also covers travel, books, fitness, nutrition, cooking and green living. Propranolol is in a family of pharmaceutical drugs called beta-blockers and sold under the brand name Inderal. This type of medication affects the heart and circulation system, and is used to prevent heart attacks and treat angina, or chest pain; hypertension or, high blood pressure; heart rhythm disorders; and prevent other heart and vascular, or blood vessel, conditions. According to the U.S. Food and Drug Administration (FDA), propranolol is also prescribed for muscle tremors, hyperthyroid conditions, to decrease the frequency and severity of migraine headaches, and for certain anxiety conditions. Beta blockers work by blocking certain sites in the central nervous system called beta-adrenergic receptor sites, as described by Drugs.com. Blocking these nerve sites decreases heart rate, blood pressure and anxiety. However, propranolol and other beta blockers can also worsen breathing disorders, such as emphysema and asthma, because they constrict the air passageways of the lungs and can cause fluid build-up in the lungs. This can result in shortness of breath, difficulty breathing and chest tightness in patients who are on propranolol for long periods of time, or who have respiratory disorders. To prevent or decrease this side effect, propranolol is prescribed in divided doses, extended-release capsules, or combined with the diuretic, hydrochlorothiazide, which causes the body to excrete fluids. As propranolol and other beta blocker drugs are used to treat hypertension, or high blood pressure, and heart rate, some patients may exper Continue reading >>
Type 2 Diabetes And Beta-blockers, What You Should Know
Type 2 Diabetes and Beta-Blockers, What You Should Know By Deborah Mitchell G+ Nov 12 2012 - 8:37am When you think about risk factors for type 2 diabetes, obesity, high blood pressure, and inactivity may come to mind. One lesser known factor is use of beta-blockers, but not all of the drugs in this class may raise the chances of developing type 2 diabetes. Some beta-blockers increase diabetes risk Beta-blockers (aka, beta-adrenergic blocking agents or beta antagonists) have been on the market for about six decades. The first clinically beneficial beta-blocker to enter the market was propranolol, which was prescribed to treat angina pectoris, a condition in which the heart's need for oxygen exceeds the available supply. Since then, propranolol and other beta-blockers have been developed and prescribed most often for arrhythmias (abnormal heart rhythms), atrial fibrillation (irregular heart rhythms), high blood pressure, and heart attack, and less often for migraines, anxiety, overactive thyroid, and glaucoma. Beta-blockers work by slowing the heart beat and reducing contractions of blood vessels in the heart, brain, and throughout the body. According to cardiologist Ragaendra R. Baliga at The Ohio State University Wexner Medical Center, "Studies show that older beta- blockers can increase a patient's risk of type 2 diabetes by more than 25 percent." While raising the risk of diabetes is not good for anyone, it is especially damaging for individuals who already have conditions that affect the heart and vascular system. In a recent issue of Heart Failure Clinics, Baliga explained that "older beta-blockers are doubled-edged swords. They save lives, but you want to avoid complications down the road, like diabetes." When some beta-blockers are used for a long time, they may Continue reading >>
Propranolol Tips: 6 Things You Should Know - Drugs.com
Propranolol is a medicine that may be used in the treatment of some heart conditions and also to reduce tremor and prevent migraines. It exerts its effects by blocking beta receptors. There are two types of beta receptors, beta-1 receptors (located in the heart) and beta-2 receptors (located in the bronchioles of the lungs and the arteries of skeletal muscle). Propranolol blocks beta-1 receptors in the heart which slows the heart rate and decreases how hard the heart has to work to pump blood around the body, decreasing blood pressure. Propranolol has a "nonselective" action - which means that it also blocks beta-2 receptors in the bronchioles, which can cause a narrowing of the bronchioles which may cause breathing difficulties in people with pre-existing lung disease. Propranolol also has a membrane-stabilizing effect at higher dosages which can affect the electrical impulses of the heart, although is not thought to contribute much to its antiarrhythmic properties. Experts are not sure how propranolol works to prevent migraines or tremors. Propranolol belongs to a class of medicines known as beta adrenergic blockers or beta blockers. May be used to treat high blood pressure (hypertension), either alone or in combination with thiazide diuretics or other medicines for hypertension. May improve the symptoms of angina and increase a person with angina's capacity to exercise. May be used in the prevention of migraine headache. May improve symptoms of hypertrophic subaortic stenosis; however, will not change the course of the disease. Approved for the treatment of essential tremor (ET). Reduces tremor amplitude but not frequency; complete suppression of tremor is rare. Appears to work best for high-amplitude, low-frequency ET. If you are between the ages of 18 and 60, take Continue reading >>
Propranolol Injection
Heres what to ask a doctor about hereditary angioedema Do not stop taking propranolol injection all of a sudden. If you do, chest pain that is worse and in some cases heart attack may occur. The risk may be greater if you have certain types of heart disease. To avoid side effects, you will want to slowly stop propranolol injection as ordered by your doctor. Call your doctor right away if you have new or worse chest pain or if other heart problems occur. It is used to treat certain types of abnormal heartbeats. What do I need to tell my doctor BEFORE I take Propranolol Injection? If you have an allergy to propranolol or any other part of propranolol injection. If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives ; itching; shortness of breath; wheezing ; cough; swelling of face, lips, tongue, or throat; or any other signs. If you have any of these health problems: Heart block , shock caused by heart problems, or slow heartbeat . This is not a list of all drugs or health problems that interact with propranolol injection. Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins ) and health problems. You must check to make sure that it is safe for you to take propranolol injection with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor. What are some things I need to know or do while I take Propranolol Injection? Tell all of your health care providers that you take propranolol injection. This includes your doctors, nurses, pharmacists, and dentists. Avoid driving and doing other tasks or actions that call for you to be alert until you see Continue reading >>
Propranolol Side Effects (hypoglycemia Or Hyperglycemia)? - Usmle Forums
Propranolol Side Effects (Hypoglycemia or Hyperglycemia)? pls forgive me for posting what may seem to u a rather trivial thread. I need some clarification. Among beta-blocker (Propranolol) side effects is hyperlipidemia, hypoglycemia, hypotension, sedation, bradycardia n bronchoconstriction. The part I don't quite get is that beta2 agonists causes increase in insulin secretion, but beta blockers cause hypoglycemia? is it because the fact that beta blockers also cause an increase in glucose that the increase in glucose overrides the insulin increase, that when u block beta receptors, the fall in glucose (causing hypoglycemia) is more prominent than the fall in insulin levels (which may cause hyperglycemia, but evidently does NOT in case of Propranolol)???? I think Inder is right. - Hypoglycemia can occur with beta-blockade because 2-adrenoceptors normally stimulate hepatic glycogen breakdown (glycogenolysis) and pancreatic release of glucagon, which work together to increase plasma glucose. Therefore, blocking 2-adrenoceptors lowers plasma glucose. A very important point, however, is that Beta blockers are "use with caution" in diabetics because they block the normal symptoms of hypoglycemia. Diabetics get tremors when they're becoming hypoglycemic and beta blockers can block any warning till their blood sugar is so low they show neurological symptoms and now the brain has been without glucose for some time... 1specific blockers have fewer metabolic side effects in diabetic patient (2 receptors on the liver and pancreas) but since they also block the heart there might be fewer symptoms of hypoglycemia so they should be used carefully too. Continue reading >>
Diabetes And Beta-blockers: What You Need To Know
People with diabetes tend to develop heart disease or stroke at an earlier age than the general population. One reason for this is that high glucose levels increase your risk of high blood pressure (hypertension). According to the American Diabetes Association, almost one in three American adults has high blood pressure. Two out of three people with diabetes have high blood pressure. Type 2 Diabetes and Hypertension High blood pressure doesn’t necessarily cause symptoms. You may feel just fine, but don’t let that fool you. Your heart is working harder than it should. It’s a serious condition, especially for people with diabetes. High blood pressure puts a lot of extra stress on your body. Over time, it can cause hardening of the arteries. It can also damage your brain, kidneys, eyes, and other organs. Treating High Blood Pressure If you have high blood pressure, your doctor may want to try other methods of treating it before turning to beta-blockers. These may include lifestyle changes and taking better control of blood glucose levels. The decision to use medication, including beta-blockers, will depend on your personal medical history. A 2015 study published in the Journal of the American Medical Association recommends drug therapy with a blood pressure reading of above 140 systolic and above 90 diastolic (140/90). For people with diabetes, lowering high blood pressure reduces the risk of developing cardiovascular problems, kidney disease, and neuropathy. Beta-Blockers Beta-blockers (beta-adrenergic blocking agents) are a class of prescription drug. They are used to treat a variety of conditions such as glaucoma, migraines, and anxiety disorders. They are also used to treat heart failure and high blood pressure. High blood pressure can increase your risk for hear Continue reading >>
Drugs That Can Raise Bg
By the dLife Editors Some medicines that are used for treating other medical conditions can cause elevated blood sugar in people with diabetes. You may need to monitor your blood glucose more closely if you take one of the medicines listed below. It’s important to note that just because a medicine has the possibility of raising blood sugar, it does not mean the medicine is unsafe for a person with diabetes. For instance, many people with type 2 diabetes need to take a diuretic and a statin to lower blood pressure and cholesterol. In these and many other cases, the pros will almost always outweigh the cons. Don’t ever take matters of medication into your own hands. Discuss any concerns you have with your healthcare provider. Certain Antibiotics Of all the different antibiotics, the ones known as quinolones are the only ones that may affect blood glucose. They are prescribed for certain types of infection. Levofloxacin (Levaquin) Ofloxacin (Floxin) Moxifloxacin (Avelox) Ciprofloxacin (Cipro, Cipro XR, Proquin XR) Gemifloxacin (Factive) Second Generation Antipsychotics These medicines are used for a variety of mental health conditions. There is a strong association between these medicines and elevated blood sugar, and frequent monitoring is recommended. Clozapine (Clozaril) Olanzapine (Zyprexa) Paliperidone (Invega) Quietiapine (Seroquel, Seroquel XR) Risperidone (Risperdal) Aripiprazole (Abilify) Ziprasidone (Geodon) Iloperidone (Fanapt) Lurasidone (Latuda) Pemavanserin (Nuplazid) Asenapine (Saphris) Beta Blockers Beta blockers are used to treat high blood pressure and certain heart conditions. Not all available beta blockers have been shown to cause high blood sugar. Atenolol Metoprolol Propranolol Corticosteroids Corticosteroids are used to treat conditions where th Continue reading >>
Beta Blockers And High Blood Sugar Readings
Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Beta Blockers and high blood sugar readings I am a 5' 8" female who weighs 135lbs. I exercise routinely, but love my chocolate! lol! I have been on a beta blocker for the past 11 years for a fast heart rate. Over the course of the past 5 years, during routine blood work, my FBS has been ranging anywhere from 102 to 128. (It should also be noted that I checked my own blood sugars one and two hours after eating on a few occasions and found that my readings went in excess of 200. On my most recent blood work a few months ago, my family doctor voiced his concern that I was indeed pre-diabetic and that I should watch what I eat. I ask him about my beta blocker and if it could cause this. He did not feel that it could, as it is a cardo select version. I decided, (with his approval) that I would wean myself off of the beta blocker and see if my blood sugars improved at all. I needed to prove this to myself...is it the medication OR do I in fact have pre-diabetes. If so, I wanted to get "on the ball" and watch my diet better. I have been off of the medication fully now for the past 12 days. My blood sugar readings have DRAMATICALLY lowered, back to the normal range! I was taking a very low dose of beta blocker, Zebeta (bisoprolol) 2.5 mg daily. This was a very welcome surprise as you can imagine. My point....I want people out there to know that this can happen. So many people are placed on beta blockers for high blood pressure etc, and may be diagnosed with diabetes. Perhaps some folks out there in this world may NOT indeed have it! Please talk to your doctor if you take one of these meds! I know that in most people it does not effect readings. This is shown Continue reading >>
