From the Research
Beta blockers are not typically used in the treatment of varicella (chickenpox) associated bleeding, as the provided evidence does not support their use in this context. The question appears to be unrelated to the provided evidence, which focuses on the use of beta blockers in variceal bleeding due to liver cirrhosis. However, based on the most recent and highest quality study available, beta blockers, such as propranolol or nadolol, are recommended for patients with variceal bleeding to reduce portal pressure and the risk of rebleeding 1. For propranolol, start with 20-40 mg twice daily orally, increasing gradually to a maximum of 160 mg twice daily. For nadolol, begin with 20-40 mg once daily, increasing to a maximum of 160 mg daily. The goal is to reduce the resting heart rate by 25% or to 55-60 beats per minute. Some key points to consider when using beta blockers in this context include:
- Beta blockers work by decreasing cardiac output and causing splanchnic vasoconstriction, which reduces portal blood flow and pressure.
- Treatment should be continued indefinitely unless contraindications develop.
- Monitor for side effects such as fatigue, dizziness, and bradycardia.
- Beta blockers are contraindicated in patients with asthma, severe heart failure, or bradycardia. In these cases, alternative treatments like endoscopic band ligation may be considered. It's essential to note that the provided evidence does not support the use of beta blockers in varicella (chickenpox) associated bleeding, and their use in this context is not recommended.