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Propranolol can aggravate breathing difficulties in patients with asthmachronic bronchitisor emphysemaIn patients with existing slow heart ratesbradycardiasand heart blocksdefects in the electrical conduction of the heartpropranolol can cause dangerously slow heart ratesand even shockPropranolol reduces the force of heart muscle contraction and can aggravate symptoms of heart failure.

Neonates whose mothers received propranolol HCl at parturition have exhibited bradycardiahypoglycemiaand/or respiratory depressionAdequate facilities for monitoring such infants at birth should be available.

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