Pharmacology of Combined ??-??-Blockade I

Wj, Louis; McNeil, John J; Drummer, Olaf H.

doi:10.2165/00003495-198400282-00003

Cited by 28 publications

(9 citation statements)

References 87 publications

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“…1981) or other beta-blockers (Boutroy 1987) could be explained on pharmacological grounds. Labetalol is a beta-blocker with alpha adrenoceptor antagonist properties which limit the bradycardia induced by beta-blockade and may cause peripheral vasodilation (Louis et al 1984). Indeed, we saw no difference in maternal heart rate between the two groups.…”

Section: Discussionmentioning

confidence: 52%

Comparison of antihypertensive efficacy and perinatal safety of labetalol and methyldopa in the treatment of hypertension in pregnancy: a randomized controlled trial

Plouin

Breart

Maillard

et al. 1988

BJOG

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Summary. Labetalol was compared with methyldopa in a randomized controlled trial involving 176 pregnant women with mild to moderate hypertension. Diastolic blood pressure below 86 mmHg was obtained in a similar proportion of women given labetalol or methyldopa. Intrauterine death occurred in four women treated with methyldopa, and the one neonatal death on day 1 occurred in the labetalol group. The average birthweight and the proportion of preterm or small‐for‐gestational‐age babies were similar in both groups. Heart rate, blood pressure, blood glucose, respiratory rate, and Silverman score of the babies did not differ between the two treatment groups, whether the comparison was made for all the infants, or only for those that were preterm or small‐for‐gestational‐age. These data indicate that maternal betablockade with labetalol is as safe as methyldopa for the fetus and the newborn.

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Section: Discussionmentioning

confidence: 52%

Comparison of antihypertensive efficacy and perinatal safety of labetalol and methyldopa in the treatment of hypertension in pregnancy: a randomized controlled trial

Plouin

Breart

Maillard

et al. 1988

BJOG

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“…Carvedilol produced reductions in HR relative to placebo in 151 patients with an acute MI ( P < 0.0001) 77. Labetalol, a nonselective β-blocker that targets α 1 -, β 1 -, and β 2 -adrenergic receptors, is used for the treatment of hypertension of all severities and during hypertensive emergencies 78,79. When given acutely, labetalol decreases peripheral vascular resistance and BP but may have limited effects on HR and cardiac output 80.…”

Section: Heart Rate Control After Myocardial Infarctionmentioning

confidence: 99%

Heart rate control with adrenergic blockade: Clinical outcomes in cardiovascular medicine

Feldman

Elton²,

Menachemi³

et al. 2010

VHRM

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The sympathetic nervous system is involved in regulating various cardiovascular parameters including heart rate (HR) and HR variability. Aberrant sympathetic nervous system expression may result in elevated HR or decreased HR variability, and both are independent risk factors for development of cardiovascular disease, including heart failure, myocardial infarction, and hypertension. Epidemiologic studies have established that impaired HR control is linked to increased cardiovascular morbidity and mortality. One successful way of decreasing HR and cardiovascular mortality has been by utilizing β-blockers, because their ability to alter cell signaling at the receptor level has been shown to mitigate the pathogenic effects of sympathetic nervous system hyperactivation. Numerous clinical studies have demonstrated that β-blocker-mediated HR control improvements are associated with decreased mortality in postinfarct and heart failure patients. Although improved HR control benefits have yet to be established in hypertension, both traditional and vasodilating β-blockers exert positive HR control effects in this patient population. However, differences exist between traditional and vasodilating β-blockers; the latter reduce peripheral vascular resistance and exert neutral or positive effects on important metabolic parameters. Clinical evidence suggests that attainment of HR control is an important treatment objective for patients with cardiovascular conditions, and vasodilating β-blocker efficacy may aid in accomplishing improved outcomes.

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“…1,2 Acute crises are usually treated with intravenous administration of the drug, but for chronic control of the arterial pressure immediate-release solid oral dosage forms are employed 3 despite its variable oral bioavailability. 4,5 Oral bioavailability of drugs depends on numerous factors affecting intestinal absorption, intestinal secretion, and intestinal and hepatic metabolism that can lead to nonlinear dependency on concentration. Nonlinear kinetic phenomena are very often responsible for variability.…”

Section: Indroductionmentioning

confidence: 99%