Question

A patient is given a prescription for propranolol (Inderal) 40 mg bid. The most important instruction for the nurse to give this patient is:

1. Take this medication on an empty stomach, as food interferes with its absorption.
2. Do not stop taking this medication abruptly; the dosage must be decreased gradually if it is discontinued.
3. If the patient experiences any disturbances in hearing, the patient should notify the health care provider immediately.
4. The patient may become very sleepy while taking this medication; do not drive.

Answer 1

The most imperative advice for a patient on propranolol is to not abruptly stop taking the medication and to gradually taper off under medical supervision due to the risk of severe cardiac effects.

Step-by-step explanation:

The correct option : b

The most important instruction for a patient prescribed propranolol, Do not stop taking this medication abruptly; the dosage must be decreased gradually if it is discontinued. Propranolol works by blocking β-receptors in the heart, which are involved in the regulation of heart rate (HR) and myocardial contractility. Abrupt withdrawal of propranolol can lead to a rebound effect with excessive cardiac stimulation, potentially resulting in chest pain, arrhythmia, or myocardial infarction.

While side effects such as drowsiness (option 4) can occur, the most critical advice is to ensure the patient understands the risk of sudden discontinuation. Bradycardia, a common side effect of β-blockers like propranolol, can occur if the medication is overprescribed, which is why patients must consult with healthcare providers before making any changes to the medication regimen. β-blockers, by inhibiting the sympathetic nervous system, reduce heart rate and allow blood vessels to dilate, thus aiding in the management of conditions such as hypertension and heart failure. These medications have a significant impact on cardiovascular function, and any alteration in dosage needs to be carefully managed. Option 3, regarding disturbances in hearing, is not typically associated with propranolol use and is less relevant than the guidance surrounding the management of the medication's dosage.