The effect of metoprolol alone and combined metoprolol–felodipin on the digital microcirculation of patients with primary Raynaud's syndrome

Csiki, Zoltán; Garai, Ildikó; Shemirani, Amir H.; Papp, Gábor; Zsóri, Katalin Szilvia; András, Csilla; Zeher, Margit

doi:10.1016/j.mvr.2011.04.004

Cited by 20 publications

(10 citation statements)

References 26 publications

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“…It seems that despite the lack of clear recommendations concerning this issue [11–13], replacing the beta blocker with a non-dihydropyridine calcium channel blocker could be critical for healing leg ulcers in some groups of elderly patients.…”

Section: Discussionmentioning

confidence: 99%

Mixed-etiology leg ulcers in a patient on long-term glucocorticoid therapy

et al. 2019

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Chronic leg ulceration is a frequent condition in elderly patients. Chronic wounds that are nonresponsive to 3-month therapy affect approximately 6.5 million people in the United States with a prevalence of 1% and costs estimated at 25 billion dollars per year. Although the main causes are venous insufficiency, lower extremity arterial disease and diabetes, in many cases the etiology is multi-factorial. Approximately 20–23% of non-healing wounds that are refractory to vascular intervention have other etiologies including vasculitis, rheumatoid arthritis and Sjögren syndrome. Adverse drug interactions are the least commonly considered, especially those which involve disease-modifying anti-rheumatic drugs. The authors present a report on a female patient with reported Sjögren syndrome, multiple morbidities and non-healing lower limb ulceration that developed during treatment with methotrexate, and no significant improvement after discontinuation of the drug and after vascular surgery. Microvascular deterioration caused by beta-blockers was considered decisive. Calcium-blocker replacement brought complete healing in the follow-up.

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Section: Discussionmentioning

confidence: 99%

Mixed-etiology leg ulcers in a patient on long-term glucocorticoid therapy

et al. 2019

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“…In this study, half of the 40 participants involved received metoprolol, and showed reduced blood viscosity compared to the control group. Interestingly, a combination treatment of beta blockers (metoprolol) with calcium channel inhibitors (felodipin) was shown to be very effective in reducing symptoms of RP (Csiki et al, 2011). …”

Section: Treatment Of Rpmentioning

confidence: 99%

Raynaud’s Phenomenon: A Brief Review of the Underlying Mechanisms

et al. 2016

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Raynaud’s phenomenon (RP) is characterized by exaggerated cold-induced vasoconstriction. This augmented vasoconstriction occurs by virtue of a reflex response to cooling via the sympathetic nervous system as well as by local activation of α2C adrenoceptors (α2C-AR). In a cold-initiated, mitochondrion-mediated mechanism involving reactive oxygen species and the Rho/ROCK pathway, cytoskeletal rearrangement in vascular smooth muscle cells orchestrates the translocation of α2C-AR to the cell membrane, where this receptor readily interacts with its ligand. Different parameters are involved in this spatial and functional rescue of α2C-AR. Of notable relevance is the female hormone, 17β-estradiol, or estrogen. This is consistent with the high prevalence of RP in premenopausal women compared to age-matched males. In addition to dissecting the role of these various players, the contribution of pollution as well as genetic background to the onset and prevalence of RP are also discussed. Different therapeutic approaches employed as treatment modalities for this disease are also highlighted and analyzed. The lack of an appropriate animal model for RP mandates that more efforts be undertaken in order to better understand and eventually treat this disease. Although several lines of treatment are utilized, it is important to note that precaution is often effective in reducing severity or frequency of RP attacks.

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“…Classic therapy includes systemic vasodilator drugs with moderate effects on symptoms such as pain [15]. Association with topical nitroglycerin proved efficacious by increasing local temperature with an average of 3 o C after 3 h of topical application (patch or ointment with 2% nitroglycerin, reapplied every 6 h), with constant maintenance of temperature for up to 12 h. The main reported adverse effect was headache 2 hours after patch application [16].…”

Section: Resultsmentioning

confidence: 99%

Nitroglycerin in Dermatology

Toader¹,

Mocanu²,

Iancu³

et al. 2020

Rev. Chim.

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Nitroglycerin has traditionally been used in medicine for over 130 years for its potent dilator effect on both venous and arterial blood vessels. Cardiovascular ischemic diseases are among the classic indications. However, the possibility to incorporate nitroglycerin in different galenic forms renders it new therapeutic potential through topical application, both in surgery and in dermatology (Raynaud syndrome, chondrodermatitis, pernio erythema, alopecia areata, ulcers of different etiologies). Nitroglycerin is used for topical treatment as 0.5%, 1% or 2% ointment, lower concentrations limiting the probability of systemic adverse effects occurence.

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The effect of metoprolol alone and combined metoprolol–felodipin on the digital microcirculation of patients with primary Raynaud's syndrome

Cited by 20 publications

References 26 publications

Mixed-etiology leg ulcers in a patient on long-term glucocorticoid therapy

Mixed-etiology leg ulcers in a patient on long-term glucocorticoid therapy

Raynaud’s Phenomenon: A Brief Review of the Underlying Mechanisms

Nitroglycerin in Dermatology

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