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Propranolol And Breathing?


mkoven
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My new pcp who is up on eds and ans stuff wanted me to try propanolol at bedtime to prevent adrenaline surges at night that wake me up and cause chest pain. I was reluctant because I've been told by other docs in the past to avoid beta-blockers with my allergic history, though it's not clear that I actually have asthma. this doc thought the dose was low enough that it wouldn't be a problem. Well last night I tried HALF a pill-- 5mgs--so a TEENY dose, and had difficulty taking a deep breath. And I'm not imagining this: I have slee apnea and cpap my machine records the number of apneas (how often I stop breathing for more than ten seconds/hr) and hypopneas (how often I take a 50% shallower breath for more than ten seconds/hour). Last night my hypopneas were much higher than usual--so I'm not imagining this. (and I certainly woke up a lot last night, so it didn't stop my awakenings, whether those were adrenaline-induced or not.)

Does this mean I shouldn't take bbs or just not propranolol?

I'm also nervous to tell the doctor that I only tried for the first time last night-- not immediately after he prescribed it, two weeks ago I don't want to seem non-compliant or difficult. Should I try another night--don't really want to, with the shallow breathing. How best to tell him? and anyone know other bb's that might cause less breathing difficulty? I'd actually like to get referred to a cardiologist to see what makes sense, but don't want to offend him. I don't want to damage this new relationship.

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If you feel safe that the CPAP will compensate for the shallower breathing, I would give it another shot. I personally have asthma and refuse to take BB, as I don't notice when I'm having an asthma attack until it's too late and I stop breathing. (This is due to years of being undiagnosed, and my body got used to not breathing right). I've had cardiologists yell and scream at me over the fact that I won't take them - denying that my asthma is that bad! Finally I talked to my PCP and he said that BB are contraindicated in cases of asthma or severe allergies and that I should never, ever take them.

As for telling the doctor, perhaps say that you were nervous about taking them, and waited until a SO or a friend could stay over in case there was a problem? And go to the cardiologist if you want to. As long as you keep your PCP in the loop most are very willing to have you see specialists (especially if the PCP is a decent doctor).

Sara

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Propranolol is a non-selective beta blocker, which means it targets Beta-1 receptors in the heart, as well as Beta-2 receptors in the lungs. The blocking of Beta-2 receptors in the lungs can create shortness of breath and asthma problems worse. There are selective beta-blockers which primarily target Beta-1 receptors located in the heart, and might work better if you has asthma for breathing problems. One such is metoprolol (aka Toprol) that many here take to help control heart rate caused by adrenaline surges. I would ask your doctor about selective vs non-selective beta blockers to determine which one might work best for you.

James

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Was going to post similar to James about trying a cardio-selective beta-blocker. I have asthma (has been severe in the past) and my doctors had quite a discussion about whether it would be safe for me to try a beta-blocker. My cardiologist talked to a respiratory physician and they decided I should try a tiny dose of Bisoprolol (cardio-selective). Luckily my asthma didn't react and I continued with the beta-blocker (however I am now trying to get off the beta-blocker as my other allergies are playing up and my immunologist doesn't want me to have emergency adrenaline whilst beta-blocked).

I would explain what happened to your PCP. If you are going to try a BB again it should probably be a selective one and given your respiratory problems being admitted to the hospital overnight sounds like a good idea.

Flop

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