Propranolol for hypertension.

[shenzys]

Would propranolol ever be prescribed in the first place over atenolol in the treatment of hypertension? If so why?
The drug crosses the BBB and causes nightmares, it can also block beta-2 receptors leading to an increased risk of breathing difficulties and vasoconstriction to those vessels leading to skeletal muscles, which does nothing to prevent hypertension. It doesn't make sense to me why this drug would be prescribed before atenolol would be, and why a pharmacist would wait until the patient would complain about having nightmares before the drug was switched to atenolol.

Is there at least one advantage of administering propranolol over atenolol for hypertension treatment?


Thank You.

[bobbin]

It doesn't make sense to me why this drug would be prescribed before atenolol would be, and why a pharmacist would wait until the patient would complain about having nightmares before the drug was switched to atenolol.

Atenolol and propranolol are not generally first-line drugs for the treatment of hypertension. ACE inhibitors, calcium channel blockers and thiazide diuretics are now recommended.

In the UK, if a beta blocker is indicated for hypertension (eg. if the patient also has angina), atenolol or bisoprolol is normally chosen first. Propranolol might be chosen if the patient also suffers from another condition which it can treat eg. frequent migraine attacks.

Which drug to prescribe first is essentially the doctor's decision so I wouldn't expect the pharmacist to question it unless there was reason to believe that it would be unsafe eg. asthma. Also, given that community pharmacists do not have access to patient's medical records, we are not normally in a position to know exactly why a specific drug has been chosen.

[shenzys]

Ok, thank you very much.