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عمومی::
پروپرانولول
Agents used include growth hormone, insulin-like growth factor, insulin, oxandrolone, testos- terone, and propranolol.
Propranolol
β-Adrenergic blockade with propranolol represents probably the most efficacious anticatabolic therapy in the treatment of burns.
Long-term use of propranolol during acute care in burn patients, at a dose titrated to reduce heart rate by 15% to 20%, was noted to diminish cardiac work (Fig. 19-13).
Stable isotope and serial body composi- tion studies showed that administration of propranolol reduces skeletal muscle wasting and increases lean body mass after burn injury.12 fte underlying mechanism of action of propranolol is still unclear; however, its effect appears to be due to an increased protein synthesis in the face of a persistent protein breakdown and reduced peripheral lipolysis.39 Data suggest that administration of propranolol given at 4 mg/kg body weight every 24 hours also markedly decreases the amount of insulin necessary to decrease elevated glucose level after burn injury (unpublished data).
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