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The Medical Journal of Australia Jul 1976
Topics: Adrenergic beta-Antagonists; Animals; Humans; Hypertension
PubMed: 10510
DOI: 10.5694/j.1326-5377.1976.tb134409.x -
Clinical Pharmacy Nov 1990The use of beta-adrenergic blocking agents in patients with congestive heart failure (CHF) is reviewed. The sympathetic nervous system plays an important compensatory... (Review)
Review
The use of beta-adrenergic blocking agents in patients with congestive heart failure (CHF) is reviewed. The sympathetic nervous system plays an important compensatory role in maintaining inotropic support of the failing heart; therefore, beta blockers have long been considered contraindicated in CHF patients. However, prolonged excessive activation of the sympathetic nervous system may be detrimental. Several clinical trials have shown improved functional status and hemodynamic indices in some patients with dilated cardiomyopathy who received beta blockers. The maximum effect required up to 12 months. Two studies also showed trends toward improved survival. Aspects of study design that appear to be associated with the observation of a favorable response to beta blockade in CHF patients are a low initial dosage, gradual adjustment of the dosage, and a sufficient duration of therapy. Trials with unfavorable results lacked one or more of those design characteristics. Mechanisms proposed to underlie the beneficial effects of beta blockers in CHF patients include up-regulation of beta-receptors, reduction in cardiac energy requirements, protection of the myocardium against norepinephrine toxicity, and anti-arrhythmic effects. Most studies were conducted in patients with idiopathic dilated cardiomyopathy; it is unknown whether beta-blocker therapy is equally beneficial in patients with CHF arising from other causes. Metoprolol is the agent for which there is the most experience; comparative efficacy trials have not been conducted. Beta-adrenergic blockers appear to be beneficial in some patients with CHF. Further trials are needed to identify the patients most likely to respond and the drugs most likely to work.
Topics: Adrenergic beta-Antagonists; Heart Failure; Humans; Research Design
PubMed: 1980240
DOI: No ID Found -
Archives of Internal Medicine Apr 1987Drugs that block beta-adrenergic receptors have become one of the most widely used classes of drugs to treat hypertension. This review puts the use of beta-blockers as... (Review)
Review
Drugs that block beta-adrenergic receptors have become one of the most widely used classes of drugs to treat hypertension. This review puts the use of beta-blockers as monotherapy for hypertension in perspective and provides reasons for choosing among the several beta-blockers available. The major reasons for discriminating within this class of drugs are related to differences in concomitant clinical conditions, differences in patient responses, and intrinsic differences among the beta-blockers. These differences relate to special properties such as beta-agonist activity (intrinsic sympathomimetic activity), beta 1-selectivity, and concomitant alpha-blockade, as well as differences in side effect profiles, excretion characteristics, and length of action of the various drugs.
Topics: Adrenergic alpha-Antagonists; Adrenergic beta-Agonists; Adrenergic beta-Antagonists; Hemodynamics; Humans; Hypertension
PubMed: 2881524
DOI: No ID Found -
British Medical Journal Apr 1978
Topics: Adrenergic beta-Antagonists; Antidotes; Humans
PubMed: 25113
DOI: No ID Found -
Midwife, Health Visitor & Community... Sep 1982
Topics: Adrenergic beta-Antagonists; Humans
PubMed: 6126798
DOI: No ID Found -
Journal of Emergency Nursing 1982
Topics: Adrenergic beta-Antagonists; Humans
PubMed: 6125617
DOI: No ID Found -
Current Opinion in Pharmacology Jun 2014β-Blockers are used for a wide range of diseases from hypertension to glaucoma. In some diseases/conditions all β-blockers are effective, while in others only certain... (Review)
Review
β-Blockers are used for a wide range of diseases from hypertension to glaucoma. In some diseases/conditions all β-blockers are effective, while in others only certain subgroups are therapeutically beneficial. The best-documented example for only a subset of β-blockers showing clinical efficacy is in heart failure, where members of the class have ranged from completely ineffective, to drugs of choice for treating the disease. Similarly, β-blockers were tested in murine asthma models and two pilot clinical studies. A different subset was found to be effective for this clinical indication. These findings call into question the current system of classifying these drugs. To consider 'β-blockers', as a single class is misleading when considering their rigorous pharmacological definition and their appropriate clinical application.
Topics: Adrenergic beta-Antagonists; Animals; Asthma; Humans; Ligands; Receptors, Adrenergic, beta-2; Signal Transduction
PubMed: 24681351
DOI: 10.1016/j.coph.2014.03.002 -
Cardiovascular Drugs and Therapy Jun 1991Despite the fact that beta blockers were introduced into clinical practice 25 years ago, new beta blockers with differing kinetic and dynamic profiles continue to be... (Review)
Review
Despite the fact that beta blockers were introduced into clinical practice 25 years ago, new beta blockers with differing kinetic and dynamic profiles continue to be developed and marketed. This overview assesses some of the more extensively studied agents from the point of view of proof of utility and the validity of claims for therapeutic advances. The clinical data suggests that despite the expectations of improvements based on kinetic and dynamic consideration, none of the newer agents have been shown unequivocally, either in terms of efficiency or tolerability, to be an advance over the reference agents, the beta 1 antagonists atenolol and metoprolol. This may be either because such improvements will not occur or because of shortcomings in the design and duration of comparative studies. There are trends to suggest that celiprolol has lesser effects on bronchial function and that it has a lesser impact on lipoprotein profiles. Approaches are suggested that might enable clinicians to appraise for themselves the validity of claims for the improved efficiency of new beta blockers.
Topics: Adrenergic beta-Antagonists; Drugs, Investigational; Humans
PubMed: 1678960
DOI: 10.1007/BF03029726 -
American Family Physician Aug 1980
Comparative Study
Topics: Adrenergic beta-Antagonists; Aged; Humans; Metoprolol; Nadolol; Propanolamines; Timolol
PubMed: 6105818
DOI: No ID Found -
Nursing Older People Sep 2004
Review
Topics: Adrenergic beta-Antagonists; Heart Failure; Humans; Hypertension; Myocardial Infarction
PubMed: 15470846
DOI: 10.7748/nop2004.09.16.6.35.c2330