title: Propranolol dosage in thyrotoxicosis.
abstract: Eighteen thyrotoxic patients receiving chronic treatment with propranolol (160 mg/day) were studied to determine the relationship between plasma propranolol concentration and drug effect. There was a considerable interindividual variability in both the plasma propranolol steady state concentration and the degree of beta-adrenergic blockade. The plasma propranolol steady state concentration correlated significantly with both beta-adrenergic blockage and weight change but not with the degree of subjective improvement. In a group of 40 patients, including 10 severely thyrotoxic patients, who had the dosage of propranolol titrated objectively preoperatively to bring about a greater than 25% reduction in exercise heart rate at the end of a dosage interval, no case of thyroid storm was encountered. Many patients, the younger and severely thyrotoxic in particular, require doses in excess of 160 mg/day to achieve this degree of beta-adrenergic blockade.
mesh_terms: D000293:Adolescent; D000328:Adult; D001835:Body Weight / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006980:Hyperthyroidism / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011433:Propranolol / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use; D013965:Thyroidectomy
chemical_list: D011433:Propranolol