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Oral propranolol treatment in infants and children
Insights
Oral propranolol effectively treats pediatric cardiac conditions like dysrhythmias and hypoxemic spells. This study shows propranolol is a valuable treatment option for children with specific heart diseases.
Area of Science:
- Pediatric Cardiology
- Pharmacology
Background:
- Cardiac dysrhythmias, idiopathic hypertrophic subaortic stenosis (IHSS), and paroxysmal hypoxemic spells are serious conditions in children.
- Effective pharmacological interventions are crucial for managing these pediatric cardiac diseases.
Purpose of the Study:
- To evaluate the efficacy of oral propranolol in treating various cardiac conditions in pediatric patients.
- To compare the effectiveness of liquid and tablet formulations of propranolol.
Main Methods:
- Sixty-four children (1 day to 20 years) received oral propranolol (0.5–4.0 mg/kg/day).
- Patients had cardiac dysrhythmias (n=41), IHSS (n=6), or right ventricular infundibular obstruction with hypoxemic spells (n=17).
- Propranolol was administered as a liquid (10 mg/ml) or tablets.
Main Results:
- Propranolol improved dysrhythmias in 31 of 41 patients, particularly supraventricular and ventricular tachycardia with prolonged QT.
- Symptoms of IHSS were eliminated in all six patients.
- Hypoxemic spells were abolished in 12 of 17 patients.
- Liquid and tablet forms showed equal efficacy; liquid allowed precise dosing in younger children.
Conclusions:
- Oral propranolol is highly effective for pediatric cardiac dysrhythmias, IHSS, and certain hypoxemic spells.
- The liquid formulation offers advantages for accurate pediatric dosing.
- Propranolol is an excellent therapeutic option for specific pediatric cardiac diseases.
Abstract:
To determine the effectiveness of oral propranolol in children, we administered 0.5 to 4.0 mg/kg/day of the drug to 64 children (age one day to 20 years); 41 with cardiac dysrhythmias, six with isiopathic hypertrophic subaortic stenosis, and 17 with paroxysmal hypoxemic spells associated with right ventricular infundibular obstruction. A new liquid form of propranolol (10 mg/ml) was administered to 37 of the younger patients, and tablets were given to the other 27. Propranolol improved the dysrhythmia in 31 of 41 patients, being notably effective in supraventricular tachycardia and ventricular tachycardia associated with a prolonged QT interval. The drug also eliminated symptoms attributed to IHSS in six of six patients and abolished hypoxemic spells in 12 of 17. The liquid and tablets were equally effective; and the liquid had the advantage of allowing for accurate dose changes in younger children. We conclude that oral propranolol is an excellent drug for use in pediatric patients with certain types of cardiac disease.