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Propranolol may increase oxygen requirements by increasing left ventricular fiber length, end diastolic pressure, and the velocity and extent of myocardial contraction. Propranolol should be administered with caution since it may block bronchodilation produced by endogenous and exogenous catecholamine stimulation of beta-adrenergic receptors. Propranolol may mask the symptoms of low blood sugar such as increased heart rate, systolic blood pressure, and systolic ejection period.
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