Propranolol hypoglycaemia in infancy — MRCPCH TAS MCQ

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HardPharmacologyPropranolol hypoglycaemia in infancyMRCPCH TAS

A 4-month-old treated for a large infantile haemangioma has poor feeding during a viral illness, then becomes pale and drowsy. Glucose is 2.1 mmol/L and tachycardia is absent. Which drug is most likely responsible?

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Correct answer: B — Propranolol

Propranolol can contribute to hypoglycaemia and mask adrenergic warning signs because of beta-blockade. Cetirizine may cause drowsiness but would not explain hypoglycaemia with absent adrenergic response. The pearl is that propranolol for haemangiomas should be used cautiously during intercurrent illness or poor intake.

Reference: BNFc; Nelson Textbook of Pediatrics; RCPCH Theory examination syllabi