Possible Interaction: Epinephrine and Propranolol

“However, recovery of blood … the presence of propranolol (3 mg/ 3 min and 0.8 mg/min) was retarded when compared with control studies (mean plasma glucose …, 50±6 mg/dl versus 66±4 mg/dl at 120 min after insulin administration) despite appropriate glucagon, epinephrine , cortisol, and … responses.”

“Both ADP and adrenaline thrshold values were significantly lower after propranolol than after metoprolol.”

“ Adrenaline infusion, therefore, caused different haemodynamic effects during non-selective β-blockade with propranolol and during β1-selective blockade with metoprolol.”

“ Propranolol , but not metoprolol, prevented this effect of adrenaline.”

“ Propranolol , but not metoprolol, reversed this insulin-antagonistic effeet of adrenaline.”

“However, pretreatment with propranolol resulted in a significant increase of the DHEA/cortisol ratio upon infusion of the β-adrenoceptor agonist epinephrine.”

“The increase in blood perfusion regularly seen after adrenaline was blocked after propranolol administration.”

“The major electrocardiographic effect of epinephrine infusion was a dose-related increase in QTc, but pretreatment with propranolol blunted this effect and tended to shorten QTc.”

“These results confirm the potentially serious interaction of propranolol and adrenaline during anaesthesia, and support the use of metoprolol instead, to obtund the cardiovascular effects of adrenaline infiltration.”

“ Propranolol and pindolol reduced myocardial oxygen demand estimated by the HR x BP product after EPI , but this response was abolished by atropine.”

“Administration of propranolol during exercise produced a clear-cut additional increase in plasma NPY-Li as well as in noradrenaline and adrenaline.”