Randomised trial comparing propranolol with atenolol in immediate treatment of suspected myocardial infarction.

Wilcox, R G; Roland, J; Banks, D C; Hampton, John R.; Mitchell, J. R. A.

doi:10.1136/bmj.280.6218.885

Cited by 135 publications

(24 citation statements)

References 6 publications

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“…Características dos estudos selecionados para avaliação da eficácia dos betabloqueadores no IAM. 34 Nos pacientes tratados dentro de sete horas do iní-cio do IAM, no estudo MIAMI, a ocorrência de um novo IAM definido foi menor nos pacientes que receberam succinato de metoprolol (70,1%) do que no grupo controle (74,0%). O grupo COMMIT, por sua vez, relatou redução relativa de 15 a 20% no grupo succinato de metoprolol.…”

Section: Infarto Agudo Do Miocárdio (Iam)unclassified

Avaliação da Inclusão de Metoprolol Oral no Formulário Farmacoterapêutico de um Hospital Universitário

Carvalho¹,

Noblat²

2022

JAFF

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ARTIGOSResumo: Objetivo: Avaliar a necessidade de inclusão do metoprolol oral no Formulário Terapêutico. Metodologia: Foi realizada uma revisão da literatura no período janeiro a março de 2012 comparando o metoprolol aos betabloqueadores selecionados de acordo com a indicação registrada na Agência Nacional de Vigilância Sanitária. Foram utilizadas as bases de dados PubMed, Web of Science, LILACS, SciELO e Bireme. Os critérios de inclusão dos estudos foram: ensaios clínicos randomizados, controlados, duplo cego, que avaliaram a eficácia dos betabloqueadores. Os critérios de exclusão foram: ensaios clínicos com controles retrospectivos. Foram incluídos na avaliação de segurança estudos selecionados na revisão de eficácia que dispunham de informações sobre efeitos adversos. A conveniência foi avaliada a partir de informações farmacocinéticas. Para a análise de custo, houve uma avaliação dos preços por região e licitação pública. Resultados e discussão: Na análise de eficácia, os estudos incluídos na insuficiência cardíaca não demonstraram diferença de benefício entre o carvedilol e metoprolol, com exceção de um estudo. Para o tratamento do infarto agudo do miocárdio, angina, hipertensão arterial sistêmica e arritmias não houve superioridade entre os representantes. Na análise de segurança, observou-se que os efeitos adversos foram leves e semelhantes para toda a classe. Há uma comodidade associada com o atenolol e metoprolol por permitirem administração única diária. Por fim, a análise de custo com o tratamento foi desfavorável para o metoprolol. Conclusão: Diante das evidências e dos critérios de seleção, é possível concluir que os dados são desfavoráveis para a inclusão do metoprolol no formulário terapêutico.Palavras-chave: seleção de medicamentos, doenças cardiovasculares, metoprolol. Abstract:Objective: To evaluate the need for inclusion of oral metoprolol Therapy Form. Methods: We performed a literature review comparing beta-blockers metoprolol selected. According to the statement recorded in the National Health Surveillance Agency (ANVISA) was made to search the databases U.S. National Library of Medicine (PUBMED), Web of Science / Institute for Scientific Information (ISI), Latin American and Caribbean Health Sciences (LILACS), Scientific Electronic Library (SCIELO) and Cochrane Library (BIREME). Inclusion criteria were studies: Clinical trials evaluating the efficacy of beta-blockers in the indications registered at ANVISA; studies with or without active control groups. Exclusion criterion was: clinical trial with retrospective non-randomized control. Were included in the safety assessment: Studies selected in the efficacy review that had data regarding adverse effects. The convenience was evaluated from information on the half-life of drugs and their dosage regimens. For the cost analysis, finally, there was a search in the website www. comprasnet.gov.br and www.consultaremedios.com where it´s possible to see the lowest prices in the region and by public bidding. Results and discussion: In the efficacy an...

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Section: Infarto Agudo Do Miocárdio (Iam)unclassified

Avaliação da Inclusão de Metoprolol Oral no Formulário Farmacoterapêutico de um Hospital Universitário

Carvalho¹,

Noblat²

2022

JAFF

View full text Add to dashboard Cite

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“…All patients studied had initially been admitted to coronary care units within 24 h after a myocardial infarction and subsequently attended an outpatient clinic whilst taking part in a study of the effects of long term administration of a ,B-adrenoceptor antagonist after myocardial infarction (Wilcox et al, 1980). The treatment regimens were either, propranolol 80 mg twice daily, atenolol 50 mg twice daily or placebo tablets twice daily.…”

Section: H J Wharrad Et Al Methodsmentioning

confidence: 99%

Effect on finger tremor of withdrawal of long‐term treatment with propranolol or atenolol.

Wharrad¹,

Birmingham²,

Cf³

et al. 1984

Brit J Clinical Pharma

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The effect of the withdrawal of long‐term beta‐adrenoceptor blockade on pulse rate and finger tremor was studied in 27 patients who had been treated for 2 years following an uncomplicated myocardial infarction with either atenolol, propranolol or placebo. During treatment, pulse rate was significantly lower in patients treated with propranolol or atenolol compared with placebo. Compared with the response in the placebo group the mean increase in tremor on withdrawal of propranolol was statistically significant for postural and for work tremor in both hands. A significant increase in tremor on withdrawal of atenolol occurred only in the postural position and in a narrow frequency band (left hand, 7‐11 Hz; right hand, 7‐9 Hz). The differences in the effect on tremor of withdrawal of treatment with propranolol or atenolol in doses which produced similar reductions in heart rate, emphasise the beta 2 classification of peripheral receptors associated with normal muscle tremor but do not exclude the involvement of beta 1‐ adrenoceptors.

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“…Moreover, the infl uence is about the same in both groups and remains statistically signifi cant even after adjustment for baseline characteristics. Thus, attempts to infer treatment efficacy by restricting attention to compliant members of the treatment group or by comparing compliant and noncompliant subjects can be deceptive (136).…”

Section: Attribution Of Eventsmentioning

confidence: 99%

Critical Issues in the Conduct and Interpretation of Clinical Trials

Louis¹,

Shapiro²

1983

Annu. Rev. Public Health

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Randomised trial comparing propranolol with atenolol in immediate treatment of suspected myocardial infarction.

Cited by 135 publications

References 6 publications

Avaliação da Inclusão de Metoprolol Oral no Formulário Farmacoterapêutico de um Hospital Universitário

Avaliação da Inclusão de Metoprolol Oral no Formulário Farmacoterapêutico de um Hospital Universitário

Effect on finger tremor of withdrawal of long‐term treatment with propranolol or atenolol.

Critical Issues in the Conduct and Interpretation of Clinical Trials

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