Why propranolol and not another beta-blocker?
I’m not sure. It’s a nonselective beta blocker. There are two receptors for adrenaline in the body: beta 1 and beta 2. When beta 1 is blocked, the action of blocking is to lower heart rate and also to lower blood pressure. Beta 2 is found in tissue like breathing passages and blocking the beta 2 receptor can cause bronchoconstriction, which means breathing passages get too narrow to breathe easily. So you wouldn’t use these in patients with asthma.
Whether you need a nonselective one to treat stage fright, I’m not sure. My suspicion is there’s something about nonselective beta blockade.
What kinds of side effects might the shooter experience?
The main one is fatigue. Because adrenaline is so important a hormone for maintaining a sense of well-being, blocking its activity can cause fatigue and depression. You can also have flare-ups of asthma in susceptible people, and erectile dysfunction.
If you use one for awhile, you’re blocking the action of adrenaline, so the body compensates by increasing density of beta receptors. Your symptoms could get worse, in something called a rebound effect, but we don’t know how long he was taking propranolol.
Wait a second, I take a beta-blocker for high blood pressure. Does that mean I can't be an Olympic shooter?
No, Ivan, you can’t be an Olympic shooter, but that has nothing to do with the beta-blocker you’re taking.