Who Can And Cannot Take Propranolol
Propranolol can be taken by adults and children. But it is not officially approved for treating high blood pressure in children under 12 years old.
It is not suitable for everyone. To make sure it is safe for you, tell your doctor before starting propranolol if you have:
- ever had an allergic reaction to propranolol or any other medicine
Tell your doctor if you’re trying to get pregnant, are already pregnant or if you’re breastfeeding.
Information About Soft Gel Ibuprofen
Ibuprofen is a Non-Steroidal Anti-Inflammatory Drug that is used to treat pain and fever. It is also sold under the brand names Advil and Motrin and is available over the counter in grocery stores, drugstores and other retail outlets. Ibuprofen softgels offer a different delivery system than traditional tablets, which can take longer to produce effects. Understanding the uses and effects of ibuprofen softgels can help consumers obtain the most benefit from the product.
Nsaids May Increase Risk Of Irregular Heartbeat Study Says
The researchers issued a warning to doctors.
They are common, over-the-counter pain meds, but researchers are issuing a warning to doctors today.
Prescribing NSAIDs seems linked to increased risk for a common heart rhythm problem known as atrial fibrillation , reported researchers in Taiwan. The number of persons with AF is on the rise; it now affects more than 6 percent of the elderly population.
A study of over 57,000 people from Taiwan ages 45 and older analyzed national data sets from years 2000, 2005 and 2010. People diagnosed with AF were matched and compared to another person without AF of the same age and sex and with similar medical conditions .
Researchers looked for an association between the use of nonsteroidal anti-inflammatory drugs, aka NSAIDs, and the risk of atrial fibrillation.
NSAIDs stop proteins called cyclooxygenase, known as COX, and fall into two classes: selective COX-2 inhibitors and nonselective COX-1/COX-2 inhibitors .
In this study, researchers defined anyone who took an NSAID for at least one day within a year of their AF as a user. Compared to nonusers, those who took an NSAID had an elevated risk of AF, the study found.
Nonselective NSAIDs were associated with an 18 percent increased odds for having AF, selective NSAIDs showed no difference, and combining both selective and nonselective NSAIDs went along with a 30 percent increased odds for having AF.
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Where Did The Story Come From
The study was carried out by researchers from the Aarhus University Hospital Denmark. Funding was provided by the Danish Medical Research Council, the Clinical Epidemiological Research Foundation and the Danish Heart Association.
The study was published in the British Medical Journal.
Generally, this research was accurately covered by the newspapers, but many did not make clear what the risk associated with taking the drugs was being compared to .
However, a problem faced by the researchers was that they assessed NSAID use through a proxy measure . As such, it is not clear whether users took NSAIDs once a day as the Daily Mail suggests.
Additionally, the Daily Express said, of the nine million people in Britain who take ibuprofen each day and at least 1.5 million who use a new class of pain reliever more than 700,000 suffer with the condition. However, it is not clear where these figures come from.
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Answers Won’t Come Soon
Nissen and colleagues are conducting a clinical trial that he and Farkouh agree should answer the ibuprofen question once and for all. That trial, now enrolling 20,000 patients, will compare Celebrex, naproxen, and ibuprofen in patients at risk of heart disease.
In that trial, patients will take their aspirin two hours before taking their study medication.
The good news is the trial will, at last, provide sorely needed information on the relative heart risks of common pain relievers.
The bad news: The study won’t start returning results until 2010.
SOURCES: Farkouh, M.E. Annals of the Rheumatic Diseases, early onlineedition, downloaded April 3, 2007. Michael Farkouh, MD, MPH, director ofclinical trials, Mount Sinai Heart; associate professor of medicine, MountSinai School of Medicine, New York. Steven Nissen, MD, chairman, department ofcardiovascular medicine, The Cleveland Clinic.
What Did The Research Involve
The study was carried out in Denmark. The researchers obtained the data for their study from a registry that had covered all non-psychiatric hospital visits since 1977 and emergency room and outpatient visits since 1995. The registry was used to identify all patients who had a first-time inpatient or outpatient diagnosis of atrial fibrillation or flutter between January 1, 1999 to December 31, 2008. The researchers aimed to assess the patients use of NSAIDS leading up to the date of their first diagnosis of atrial fibrillation or flutter .
Controls were selected from the Danish Civil Registration System, and matched each case for age and sex. The registration system records vital statistics of the Danish population. For each person who had atrial fibrillation or flutter, 10 controls were selected. These controls were then assigned an index date, which matched their paired cases first instance of atrial fibrillation or flutter, so that their NSAID use could be assessed at the same point in time as their paired case.
Information on prescriptions of NSAIDs was provided by a regional prescription database. In Denmark all NSAIDS are available by prescription only. However, the researchers say that regular users of ibuprofen are typically registered in the database because the cost is automatically part-funded when prescribed by a doctor. The researchers assessed prescriptions of NSAIDS prior to the index date in cases and controls.
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Ibuprofen Linked To Irregular Heart Rhythm
Commonly used painkillers including ibuprofen increase the risk of developing an irregular heart rhythm by up to 40 per cent, according to a new study.
The anti-inflammatories, which are widely available in supermarkets and pharmacies, have been previously linked to a higher chance of heart attacks and strokes.
But a new study has shown for the first time a connection between the drugs and atrial fibrillation, also known as irregular heart rhythm or flutter.
The condition is more common than heart failure and stroke, and is linked to a higher long-term risk of developing both.
Experts examined the records of 32,602 patients with flutter between 1999 and 2009 and compared each to ten randomly selected control patients.
People who had recently begun using non-steroidal anti-inflammatory drugs , which include ibuprofen, were found to have a 40 per cent higher chance of flutter, equivalent to about four extra cases per year per 1000 people.
Newer forms of the drugs known as selective COX-2 inhibitors, were associated with a 70 per cent higher risk in new users, or seven more cases per 1000 people each year.
Older people were found to be most at risk from the drugs, and patients with chronic kidney disease or rheumatoid arthritis were particularly vulnerable when starting cox-2 inhibitors.
The threat was lower in patients who had been using the drugs for longer than two months because people who were susceptible were likely to experience symptoms early on, researchers said.
Shortness Of Breath Or Chest Pain After Covid
Shortness of Breath
You want to consult a doctor if any of your symptoms are severe, especially shortness of breath, Post says. She recommends using a commercially available O2 saturation monitor.
Shortness of breath by itself is not always a sign of a serious problem, but if you have that symptom along with low O2 , that is a reason to be concerned. Sometimes people are short of breath with exertion after COVID-19 because they have been less active for a long time and need to gradually build their fitness level back up.
COVID-19 Chest Pain
What about lingering chest pain, another common post-COVID complaint? Chest pain may be nothing serious, but if you are having severe chest pain, get help, especially if it is persistent or if you are also having nausea, shortness of breath or lightheadedness: These could be symptoms of a heart attack.
If you have chest pain when you inhale, you might have lung inflammation. Sudden, severe chest pain could be a blood clot in the lung , Post says.
Family doctor or cardiologist?
If your symptoms are not severe but you want to be checked out, Post says a cardiologist doesnt need to be your first stop if youve never had heart problems before and are not at risk. For nonemergency post-COVID-19 symptoms, your primary care practitioner can advise you, she says.
Heart Failure and COVID-19
- Shortness of breath, especially with exertion
- Shortness of breath when lying down
- Leg swelling
- Frequent urination at night
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Cautions With Other Medicines
There are some medicines that may interfere with the way propranolol works.
Tell your doctor if you’re taking:
- other medicines for high blood pressure. The combination with propranolol can sometimes lower your blood pressure too much. This may make you feel dizzy or faint. If this keeps happening to you, tell your doctor – they may change your dose.
- other medicines for an irregular heartbeat such as amiodarone or flecainide
- other medicines which can lower your blood pressure. These include some antidepressants, nitrates , baclofen , medicines for an enlarged prostate gland like tamsulosin, or Parkinson’s disease medicines such as levodopa.
- asthma or chronic obstructive pulmonary disease medicines
- diabetes medicines, particularly insulin propranolol may make it more difficult to recognise the warning signs of low blood sugar. Speak to your doctor if you have low blood sugar levels without getting any of the usual warning signs. You should check your blood sugar after exercise, and follow usual advice about checking it before driving, or operating machinery.
- medicines to treat nose or sinus congestion, or other cold remedies
- medicines for allergies, such as ephedrine, noradrenaline or adrenaline
- non-steroidal anti-inflammatory medicines , such as ibuprofen, diclofenac and naproxen. These medicines may increase your blood pressure, so it’s best to keep them to a minimum.
How To Cope With Side Effects Of Propranolol
What to do about:
- feeling tired, dizzy or light-headed as your body gets used to propranolol, these side effects should wear off. If propranolol makes you feel dizzy, sit or lie down until you feel better. Try to avoid alcohol as it will make you feel worse.
- cold fingers or toes put your hands or feet under warm running water, massage them and wiggle your fingers and toes. Do not smoke or have drinks with caffeine in this can make your blood vessels narrower and further restrict blood flow to your hands and feet. Try wearing mittens and warm socks. Do not wear tight watches or bracelets.
- difficulties sleeping or nightmares try taking your propranolol in the morning. If you have to take it more than once a day, speak to your doctor. They may be able to change your propranolol to the slow release form.
- feeling sick stick to simple meals and do not eat rich or spicy food. It might help to take your propranolol after a meal or snack.
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Ibuprofen Risky For Heart Patients
Common Pain Drug May Cut Aspirin Lifeline in People at High Risk for Heart Disease
April 4, 2007 — The common painkiller ibuprofen may boost heart attack risk by blocking the lifesaving effects of aspirin, a controversial study shows.
âThe public health impact of this is monstrous,” Michael Farkouh, MD, MPH, director of clinical trials at Mount Sinai Heart, tells WebMD.
âIbuprofen is relatively safe except when we give it with aspirin to people at high risk of heart attack,” Farkouh says. “Only when given with aspirin do we see an excess of heart attacks.”
Farkouh admits this is a controversial conclusion — and that the study, which was not designed to look at ibuprofen safety, does not prove that ibuprofen is harmful to people at high risk of heart disease.
But he says the study provides a clear warning sign that ibuprofen is risky for people who need the blood-clot-reducing effect of daily low-dose aspirin.
âThose taking aspirin in the ibuprofen arm of the study had a ninefold excess of heart attacks,” Farkouh says.
Steve Nissen, MD, chairman of cardiovascular medicine at The Cleveland Clinic and past president of the American College of Cardiology, urges caution. He notes that the findings are based on only eight heart attacks among thousands of high-risk patients taking ibuprofen and aspirin.
Farkouh and colleagues report their findings in the early online issue of the BMJ specialty journal Annals of the Rheumatic Diseases.
What Do Heart Palpitations Feel Like
Heart palpitations produce a sensation where it feels like the heart is fluttering, pounding, or skipping beats. Many people are scared when they feel heart palpitations. The good news is that most causes of heart palpitations are not serious and do not need treatment. If you know what causes heart palpitations, it may ease your mind when you feel them. However, some causes of heart palpitations are serious so you should learn when to be concerned about heart palpitations and when to see a doctor.
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Are Drugs That Increase Heart Rate Dangerous
In younger patients without any medical issues like heart disease or high blood pressure, mild elevations in heart rate related to medications would not likely cause any problems,says Jeffrey Landsman, MD, a primary care provider at Mercy Personal Physicians in Lutherville, Maryland.
In older patients or patients with significant underlying conditions, a rapid heartbeat may be a concern, Dr. Landsman adds.
Some symptoms of a;dangerously high heart rate include:
- Chest pressure, tightness or pain
- Shortness of breath
In extreme cases, a dangerously high heart rate can lead to unconsciousness or cardiac arrest.
Heart rates that are too high may decrease your hearts ability to effectively deliver blood and oxygen to the body, says Aaron Emmel, Pharm.D., founder ofPharmacy Tech Scholar. They can also cause an irregular heart rhythm, which is a medical emergency. Shortness of breath, lightheadedness, palpitations, chest pain, or fainting would all be serious signs that warrant medical attention.
When To Get Help For Heart Palpitations
Heart palpitations can have many causes beyond menopause, such as thyroid imbalances, anemia, diabetes, some infections, low blood pressure, and heart problems. While these flutters are usually not serious, when it comes to heart issues, you dont want to mess around. Heart disease is the leading cause of death in women, and your risk increases after menopause. ;So, its wise to talk to your doctor about this symptom when you start to notice it.
You should also familiarize yourself with symptoms of a heart attack. Heart palpitations arent one of the common symptoms, but heart attacks often present themselves differently in women than men. Many women dont always experience the classic symptoms and delay treatment so its important to be proactive when it comes to one of your biggest health risks.
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What Are Ectopic Beats
Ectopic beats are early or extra heartbeats which can cause you to have palpitations.
They happen when an impulse, usually released from your hearts own natural pacemaker , causes an extra or early heartbeat somewhere else along the hearts electrical system. This can lead to a short pause before or after the extra beat, giving you the sensation of a missed beat.
Ectopic beats are usually harmless and don’t mean you have a heart condition. You usually won’t need treatment unless they happen often, or they start to bother you.
The two most common types of ectopic beats are:
- premature atrial contraction , where the early electrical impulse occurs in the atria .
- premature ventricular contraction , where the early electrical impulse occurs in the ventricles .
How To Slow The Palpitations
Early research shows that stress, insomnia, and depression may be contributing factors. So, making changes to reduce stress, sleep better, and treat depression may help. Here are some more steps to take at home.
Get a baseline. Find out what your normal pulse rate during exercise and at rest. This will help you calculate how much faster your heart is beating during palpitations. Menopause heart palpitations may increase heart rate by eight to 16 beats per minute; a larger increase may indicate a more serious issue.
The easiest way to check your heart rate is with a fitness tracker like a FitBit or Apple watch or a chest strap monitor like Polar. Sometimes an episode can feel worse than it really is and seeing that your heart rate isnt as elevated as it feels can be reassuring. It is also helpful information to share with your doctor.
Limit caffeine. Its stimulant that may contribute to heart palpitations. Remember, coffee isnt the only source of caffeine. Non-herbal teas, including green tea, contain the stimulant. Even decaf teas have a little caffeine. Chocolate, energy drinks, and soda are other sources.
Read drug labels. Over-the-counter medications, such as antihistamines, decongestants, allergy remedies, and diet pills, often contain ingredients that are stimulants, which may affect your heart. If youre taking any of these or any prescription meds and experiencing irregular heartbeats, check with your doctor to find out if they may be related.
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