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Acute Organic Brain Syndrome From Nadolol Therapy

Robert Wilbur; Frank A. Kulik, MD; Thomas C. Brecht, PhD
Arch Intern Med. 1981;141(12):1723-1724. doi:10.1001/archinte.1981.00340130161046.
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To the Editor.  —Nadolol is a noncardioselective β-adrenoreceptor blocking agent that is suitable for once-a-day oral administration.1 Recently we studied a patient who had an acute organic brain syndrome develop from nadolol therapy.

Report of a Case.  —A 56-year-old woman with a pretreatment blood pressure (BP) of 190/110 mg Hg was seen. Her family physician had placed her on a regimen of nadolol, 40 mg/day orally, on Feb 20, 1981. The patient also received tetracycline hydrochloride and noscapine, 15 mg, phenylephrine hydrochloride, 10 mg, and guaifenesin, 100 mg orally, for an upper respiratory tract infection. The latter three drugs were given as Conar expectorant.On Feb 22, the patient fainted. On examination in the hospital emergency room, her BP was 160/100 mm Hg, and her pulse rate was 80 beats per minute. She was admitted to the hospital. Noscapine, phenylephrine, and guaifenesin therapy was discontinued immediately. Nadolol therapy was


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