Lipid-soluble and water-soluble beta-blockers. Comparison of the central nervous system depressant effect

Gengo, Francis M.

doi:10.1001/archinte.147.1.39

Cited by 41 publications

(17 citation statements)

References 23 publications

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“…The study of beta-blockers may require particularly sensitive experimental designs and measures than are required for drugs with marked CNS effects such as PCP and barbiturates (e.g., Moerschbaecher and Thompson 1980). Some studies in humans have shown a correlation between psychomotor changes and plasma concentrations of propranolol (Salem and McDevitt 1983;Gengo et al 1987). Although plasma propranolol concentrations were increased in all baboons in this study, a relationship with behavioral performances was not obtained.…”

Section: Discussioncontrasting

confidence: 54%

Performance of baboons under a repeated acquisition procedure during chronic oral exposure to atenolol and propranolol

Turkkan

Hienz

1992

Psychopharmacology

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Repeated acquisition behavioral performances of normotensive and renovascular hypertensive baboons were tested before, during, and following chronic oral dosing with the beta-adrenergic antagonists atenolol HCl (2.6 mg/kg/day PO), and d,l propranolol HCl (6.8 mg/kg twice daily PO) in separate studies. Each study administered active drug for 21 consecutive days preceded and followed by 14-day baseline and recovery periods, respectively. Animals pressed five keys in sequence for food reinforcement during daily experimental sessions which consisted of alternating acquisition (new sequence learning) and performance (previously learned) task components. Atenolol increased response latencies during acquisition in comparison to performance components, and during early portions of sessions. Propranolol also increased response latencies during acquisition components in early periods of sessions, but fewer dependent measures were affected, and the magnitude of increases in response latencies was smaller (12% +/- 5 SEM) as compared with atenolol (47% +/- 13). Test doses of phencyclidine HCl (PCP) increased latencies to the same degree as atenolol. PCP markedly reduced accuracy, while atenolol or propranolol did not. Blood pressures remained stable under atenolol, and decreased by approximately 10-15 mmHg under propranolol. No differences between renovascular hypertensive and normotensive baboons were found as a function of drug conditions. Drug effects were not dependent on plasma propranolol concentration.

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Section: Discussioncontrasting

confidence: 54%

Performance of baboons under a repeated acquisition procedure during chronic oral exposure to atenolol and propranolol

Turkkan

Hienz

1992

Psychopharmacology

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“…El nadolol es más fácil de administrar debido a su vida media más larga, permitiendo administrarse una vez al día. Adicionalmente, tiene menor liposolubilidad, no cruza la barrera hematoencefálica y por esta razón tiene menores efectos secundarios en el sistema nervioso central 57 . El propranolol es comúnmente iniciado a una dosis de 20 mg 2 veces al día, mientras que el nadolol se comienza a dosis de 40 mg por día.…”

Section: Recomendacionesunclassified

Consenso Mexicano de Hipertensión Portal

Narváez-Rivera

Cortéz-Hernández

González-González

et al. 2013

Revista de Gastroenterología de México

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The aim of the Mexican Consensus on Portal Hypertension was to develop documented guidelines to facilitate clinical practice when dealing with key events of the patient presenting with portal hypertension and variceal bleeding. The panel of experts was made up of Mexican gastroenterologists, hepatologists, and endoscopists, all distinguished professionals. The document analyzes themes of interest in the following modules: preprimary and primary prophylaxis, acute variceal hemorrhage, and secondary prophylaxis. The management of variceal bleeding has improved considerably in recent years. Current information indicates that the general management of the cirrhotic patient presenting with variceal bleeding should be carried out by a multidisciplinary team, with such an approach playing a major role in the final outcome. The combination of drug and endoscopic therapies is recommended for initial management; vasoactive drugs should be started as soon as variceal bleeding is suspected and maintained for 5 days. After the patient is stabilized, urgent diagnostic endoscopy should be carried out by a qualified endoscopist, who then performs the corresponding endoscopic variceal treatment. Antibiotic prophylaxis should be regarded as an integral part of treatment, started upon hospital admittance and continued for 5 days. If there is treatment failure, rescue therapies should be carried out immediately, taking into account that interventional radiology therapies are very effective in controlling refractory variceal bleeding. These guidelines have been developed for the purpose of achieving greater clinical efficacy and are based on the best evidence of portal hypertension that is presently available.

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“…In the authors' experience, intolerance to one may be overcome by shifting to the other. Nadolol may be more convenient since it is administered once a day, and due to its low-lipid solubility may have lower potential for central side effects [69] . Timolol has also low liposolubility [69] , and has the greatest ␤ 2 -adrenoceptor-blocking effect [70] .…”

Section: Choice Of ␤ -Blockermentioning

confidence: 99%

Variceal Bleeding: Pharmacological Therapy

Bosch

Abraldes

2005

Dig Dis

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The complications of portal hypertension are totally prevented if hepatic venous pressure gradient is decreased below 12 mm Hg. Besides, if this target is not achieved, a 20% decrease in portal pressure from baseline levels offers an almost total protection from variceal bleeding. This sets the rationale for drug therapy to reduce portal pressure in portal hypertension. Pharmacological therapy to decrease portal pressure includes vasoconstrictors to decrease portal blood inflow, vasodilators to decrease hepatic resistance, and combination therapy. Oral agents, such as b-adrenergic blockers and organic nitrates, are used for long-term prevention of variceal bleeding, while parenteral agents, such as somatostatin (and analogues) and terlipressin, are used for the treatment of acute variceal bleeding.

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Lipid-soluble and water-soluble beta-blockers. Comparison of the central nervous system depressant effect

Cited by 41 publications

References 23 publications

Performance of baboons under a repeated acquisition procedure during chronic oral exposure to atenolol and propranolol

Performance of baboons under a repeated acquisition procedure during chronic oral exposure to atenolol and propranolol

Consenso Mexicano de Hipertensión Portal

Variceal Bleeding: Pharmacological Therapy

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