The Pharmacologic Treatment of Uncomplicated Arterial Hypertension in Patients With Airway Dysfunction

Pharmacological modulation of β-adrenoceptor function in patients with coexisting chronic obstructive pulmonary disease and chronic heart failure

“…4 reports citing acute bronchospasm [15] and increased airway hyperresponsiveness (AHR) [16] after their administration.…”

“…This is to ensure that no patient is denied the benefits of β-blockers. Therefore, although β-blockers can be introduced in any medical setting for treating patients with concurrent COPD and CHF, we believe that it still seems appropriate to only use those β-blockers that are more selective for the β 1 -AR but without ISA, at the lowest dose and to titrate them slowly (table 5) with attention to lung function and symptoms, adding an inhaled antimuscarinic agent when bronchodilation is needed [15,99].…”

“…β-Blockers with β 2 -agonist activity (celiprolol) might preferable to conventional β 1 -blockers, but there is some risk that bronchospasm may occur in certain individuals and the bronchodilator response to inhaled β 2 -agonists might be impaired [15]. β 1 -blockers that modulate the endogenous production of nitric oxide (nebivolol) are another interesting option.…”

Pharmacology and Therapeutics of Bronchodilators

“…Although cardioselective ␤-AR blockers have been designed to target ␤ 1 -ARs but avoid ␤ 2 -ARs in the lung and elsewhere, so called cardioselective ␤-AR blockers (such as atenolol and bisoprolol) are only relatively selective and exert significant ␤ 2 -AR antagonism at therapeutic doses, although to a lesser extent than nonselective ␤-AR blockers such as propranolol. Thus, it might be considered counterintuitive to prescribe both ␤-AR blockers and ␤ agonists in the same patient, even when they are targeting different organs (Cazzola et al, 2002c;Matera et al, 2010). In fact, there is some risk that bronchospasm may occur in certain patients and that the bronchodilator response to inhaled ␤ 2 -AR agonists might be impaired with these agents.…”

Comparative Effects of a Two-Week Treatment with Nebivolol and Nifedipine in Hypertensive Patients Suffering from COPD

“…β 1 -Adrenoceptor blocking agents with ancillary properties, such as β 2 -agonist activity and/or the modulation of endogenous production of nitric oxide (NO), could be preferable to ‘conventional’ β 1 -blockers. However, they may elicit bronchospasm in some individuals and impair the bronchodilator response to inhaled β 2 -agonists [6]. …”