Skeletal formula of propranolol, the first clinically successful beta blocker
An 80 mg capsule of extended-release propranolol
Dichloroisoprenaline, the first beta blocker
A mixture of 20 mg and 10 mg propranolol tablets
Propranolol

Propranolol, sold under the brand name Inderal among others, is a medication of the beta blocker class.

- Propranolol

In 1964, James Black synthesized the first clinically significant beta blockers—propranolol and pronethalol; it revolutionized the medical management of angina pectoris and is considered by many to be one of the most important contributions to clinical medicine and pharmacology of the 20th century.

- Beta blocker
Skeletal formula of propranolol, the first clinically successful beta blocker

12 related topics

Alpha

Archimedean spiral drawings from a man with a unilateral essential tremor. The spiral on the left was drawn by the subject using the left hand, and the one on the right using the right hand.

Essential tremor

Medical condition characterized by involuntary rhythmic contractions and relaxations (oscillations or twitching movements) of certain muscle groups in one or more body parts of unknown cause.

Medical condition characterized by involuntary rhythmic contractions and relaxations (oscillations or twitching movements) of certain muscle groups in one or more body parts of unknown cause.

Archimedean spiral drawings from a man with a unilateral essential tremor. The spiral on the left was drawn by the subject using the left hand, and the one on the right using the right hand.

When symptoms are sufficiently troublesome to warrant treatment, the first medication choices are beta blockers such as propranolol or alternately, nadolol and timolol.

James Black (pharmacologist)

Scottish physician and pharmacologist.

Scottish physician and pharmacologist.

He went to work for ICI Pharmaceuticals in 1958 and, while there, developed propranolol, a beta blocker used for the treatment of heart disease.

Triiodothyronine (T3, pictured) and thyroxine (T4) are both forms of thyroid hormone.

Hyperthyroidism

Condition that occurs due to excessive production of thyroid hormones by the thyroid gland.

Condition that occurs due to excessive production of thyroid hormones by the thyroid gland.

Triiodothyronine (T3, pictured) and thyroxine (T4) are both forms of thyroid hormone.
Illustration depicting enlarged thyroid that may be associated with hyperthyroidism
Most common causes of hyperthyroidism by age.

Medications such as beta blockers may control the symptoms, and anti-thyroid medications such as methimazole may temporarily help people while other treatments are having an effect.

Some minimal effect on thyroid hormone production however also comes with propranolol—which has two roles in the treatment of hyperthyroidism, determined by the different isomers of propranolol.

Illustration depicting angina

Variant angina

Syndrome typically consisting of angina in contrast to stable angina which is generally triggered by exertion or intense exercise, commonly occurs in individuals at rest or even asleep and is caused by vasospasm, a narrowing of the coronary arteries due to contraction of the heart's smooth muscle tissue in the vessel walls.

Syndrome typically consisting of angina in contrast to stable angina which is generally triggered by exertion or intense exercise, commonly occurs in individuals at rest or even asleep and is caused by vasospasm, a narrowing of the coronary arteries due to contraction of the heart's smooth muscle tissue in the vessel walls.

Illustration depicting angina
Prinzmetal angina

And, they should avoid any of the recreational and therapeutic drugs listed in the above Signs and symptoms and risk factors sections as well as blockers of beta receptors such as propranolol which may theoretically worsen vasospasm by inhibiting beta-2 adrenergic receptor's vasodilation effect mediated by these receptors' naturally occurring stimulator i.e. epinephrine.

Illustration depicting angina

Angina

Chest pain or pressure, a symptom of coronary heart disease, usually due to insufficient blood flow to the heart muscle .

Chest pain or pressure, a symptom of coronary heart disease, usually due to insufficient blood flow to the heart muscle .

Illustration depicting angina
Diagram of discomfort caused by coronary artery disease. Pressure, fullness, squeezing or pain in the center of the chest. Can also feel discomfort in the neck, jaw, shoulders, back or arms.

Beta blockers (e.g., carvedilol, metoprolol, propranolol) have a large body of evidence in morbidity and mortality benefits (fewer symptoms, less disability and longer life) and short-acting nitroglycerin medications have been used since 1879 for symptomatic relief of angina.

Beta blockers, specifically B1 adrenergic blockers without intrinsic sympathomimetic activity are the most preferred for the angina treatment out of B1 selective and non-selective as well as B1 ISA agents.

Writing by a person with Parkinson's disease

Tremor

Involuntary, somewhat rhythmic, muscle contraction and relaxation involving oscillations or twitching movements of one or more body parts.

Involuntary, somewhat rhythmic, muscle contraction and relaxation involving oscillations or twitching movements of one or more body parts.

Writing by a person with Parkinson's disease

Essential tremor may be treated with beta blockers (such as propranolol and nadolol) or primidone, an anticonvulsant

Skeletal formula of propranolol, the first clinically successful beta blocker

Metoprolol

Skeletal formula of propranolol, the first clinically successful beta blocker

Metoprolol, sold under the brand name Lopressor, among others, is a selective β1 receptor blocker medication.

Due to the high penetration across the blood-brain barrier, lipophilic beta blockers such as propranolol and metoprolol are more likely than other less lipophilic beta blockers to cause sleep disturbances such as insomnia, vivid dreams and nightmares.

Peak flow meters are used to measure the peak expiratory flow rate, important in both monitoring and diagnosing asthma.

Asthma

Long-term inflammatory disease of the airways of the lungs.

Long-term inflammatory disease of the airways of the lungs.

Peak flow meters are used to measure the peak expiratory flow rate, important in both monitoring and diagnosing asthma.
Salbutamol metered dose inhaler commonly used to treat asthma attacks.
Fluticasone propionate metered dose inhaler commonly used for long-term control.
Rates of asthma in 2017
Ebers Papyrus detailing treatment of asthma
1907 advertisement for Grimault's Indian Cigarettes, promoted as a means of relieving asthma. They contained belladonna and cannabis.
Figure A shows the location of the lungs and airways in the body. Figure B shows a cross-section of a normal airway. Figure C shows a cross-section of an airway during asthma symptoms.
alt=A tissue cross section of the airway showing a stained pink wall and an inside full of white mucous|Obstruction of the lumen of a bronchiole by mucoid exudate, goblet cell metaplasia, and epithelial basement membrane thickening in a person with asthma.
Diagram of asthma
Asthma deaths per million persons in 2012{{refbegin|3}}{{legend|#ffff20|0–10}}{{legend|#ffe820|11–13}}{{legend|#ffd820|14–17}}{{legend|#ffc020|18–23}}{{legend|#ffa020|24–32}}{{legend|#ff9a20|33–43}}{{legend|#f08015|44–50}}{{legend|#e06815|51–66}}{{legend|#d85010|67–95}}{{legend|#d02010|96–251}}{{refend}}
alt=A map of the world with Europe shaded yellow, most of North and South America orange and Southern Africa a dark red|Disability-adjusted life year for asthma per 100,000 inhabitants in 2004.<ref>{{cite web|url=https://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html |title=WHO Disease and injury country estimates |year=2009 |work=World Health Organization |access-date=November 11, 2009| archive-url=https://web.archive.org/web/20091111101009/http://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html|archive-date= 11 November 2009 | url-status= live}}</ref>{{refbegin|3}}{{legend|#b3b3b3|no data}}{{legend|#ffff65|0-100}}{{legend|#fff200|100–150}}{{legend|#ffdc00|150–200}}{{legend|#ffc600|200–250}}{{legend|#ffb000|250–300}}{{legend|#ff9a00|300–350}}{{legend|#ff8400|350–400}}{{legend|#ff6e00|400–450}}{{legend|#ff5800|450–500}}{{legend|#ff4200|500–550}}{{legend|#ff2c00|550–600}}{{legend|#cb0000|>600}}{{refend}}

Other potential triggers include medications such as aspirin and beta blockers.

Beta blocker medications such as propranolol can trigger asthma in those who are susceptible.

Kim Jong-su

North Korean sport shooter who competed at the 2004 Summer Olympics in Athens and 2008 Summer Olympics in Beijing.

North Korean sport shooter who competed at the 2004 Summer Olympics in Athens and 2008 Summer Olympics in Beijing.

On August 15, 2008, three days after Kim won his third Olympic medal, the International Olympic Committee announced that he had tested positive for the banned substance propranolol during a doping test.

Propranolol is a beta blocker that is mainly used to treat hypertension, but also prevents trembling.

Woman with migraine headache

Migraine

Primary headache disorder characterized by recurrent headaches that are moderate to severe.

Primary headache disorder characterized by recurrent headaches that are moderate to severe.

Woman with migraine headache
Animation of cortical spreading depression
The Head Ache, George Cruikshank (1819)
A trepanated skull, from the Neolithic. The perimeter of the hole in the skull is rounded off by ingrowth of new bony tissue, indicating that the person survived the operation.

Due to few medications being approved specifically for the preventative treatment of migraine headaches; many medications such as beta-blockers, anticonvulsive agents such as topiramate or sodium valproate, antidepressants such as amitriptyline and calcium channel blockers such as flunarizine are used off label for the preventative treatment of migraine headaches.

Guidelines are fairly consistent in rating the anticonvulsants topiramate and divalproex/sodium valproate, and the beta blockers propranolol and metoprolol as having the highest level of evidence for first-line use for migraine prophylaxis in adults.