A comparison of four beta‐adrenoceptor antagonists in patients with asthma.

Benson, MK; Berrill, W T; Cruickshank, J. M.; Sterling, G. M.

doi:10.1111/j.1365-2125.1978.tb01647.x

Cited by 77 publications

(34 citation statements)

References 4 publications

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“…Cardioselective drugs are better tolerated in patients with asthma, although clinically significant bronchoconstriction may still occur (Astrom, 1975;Skinner et al, 1976;Benson et al, 1978;Ellis et al, 1981). However, compara-tive studies between different cardioselective 1-adrenoceptor blockers in asthmatic patients have shown little differences in their effect on airway calibre (Vilsvik & Schaanning, 1976;Lofdahl & Svedmyr, 1981).…”

Section: Discussionmentioning

confidence: 99%

Assessment of airways, tremor and chronotropic responses to inhaled salbutamol in the quantification of beta 2‐adrenoceptor blockade.

Lipworth

Brown

McDevitt

1989

Brit J Clinical Pharma

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1 The purpose of the study was to assess and compare the effects of inhaled salbutamol on heart rate (HR), finger tremor (Tr) and specific airways conductance (sGaw) in the measurement of 32-adrenoceptor blockade in normal subjects. 2 Five healthy volunteers were given oral doses of atenolol 50 mg, 100 mg, 200 mg (AS0, A100, A200), propranolol 40 mg (P40) or identical placebo (P1) in a single-blind crossover design. 3 Three hours after drug ingestion, dose-response curves were constructed using cumulative doses of inhaled salbutamol: 200 ,g, 700,ug, 1700 ,ug, 3200 ,ug, 6200,ug. HR, Tr and sGaw were measured at each dose increment, made every 20 min. 4 Increasing doses of atenolol were associated with progressive reduction in salbutamol induced ,-adrenoceptor responses. The greatest attenuation occurred with propranolol. These effects on ,B-adrenoceptor responses were similar for HR, Tr and sGaw. Geometric mean dose ratios (compared with placebo) for AS0, A100, A200 and P40 were as follows HR: 1.98, 2.75, 4.29; Tr: 1.60, 3.78, 6.34, 80.50; sGaw: 1.08, 4.35, 12.30, 66.0 (no dose ratio was obtained for HR with P40). 5 These results showed that atenolol and propranolol attenuated the effects of salbutamol on HR to a similar degree as Tr and sGaw. Furthermore, the variability was least in the measurement of chronotropic responses, suggesting that this may be used to quantify 132-adrenoceptor antagonism. The B1-adrenoceptor selectivity of atenolol was a dosedependent phenomenon, although the 132-adrenoceptor blockade of A200 was much less than with P40.

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Section: Discussionmentioning

confidence: 99%

Assessment of airways, tremor and chronotropic responses to inhaled salbutamol in the quantification of beta 2‐adrenoceptor blockade.

Lipworth

Brown

McDevitt

1989

Brit J Clinical Pharma

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“…This assumption is difficult to prove but clinical studies of oral ,-adrenoceptor antagonists in patients with asthma are in general agreement with our findings. Allowing for the different doses of drug used in different studies the fall in FEV1 or sGaw has usually been least with practolol and atenolol, rather more after acebutolol and most after propranolol (Skinner, Palmer & Kerridge, 1975;Vilsvik & Schaanning, 1976;Benson et al, 1978).…”

Section: Discussionmentioning

confidence: 99%

Bronchial and cardiac beta‐adrenoceptor blockade‐a comparison of atenolol, acebutolol and labetalol.

Gribbin¹,

Mackay²,

Baldwin³

et al. 1981

Brit J Clinical Pharma

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Bronchial and cardiac beta‐adrenoceptor blockade have been compared in six normal subjects after three beta‐adrenoceptor antagonists. Single and double doses of atenolol (50 and 100 mg), acebutolol (100 and 200 mg) and labetalolol (150 and 300 mg) were studied on separate occasions. 2 Salbutamol airway dose‐response curves were obtained by measuring the airway response as the change in specific airway conductance (sGaw) after increasing doses of inhaled salbutamol. Bronchial beta‐adrenoceptor blockade was assessed after each drug as the dose of salbutamol needed to cause a 50% increase in sGaw (sGaw D50). 3 Cardiac beta‐adrenoceptor blockade was assessed after the same doses of each beta‐adrenoceptor antagonist, by measuring the percentage reduction in exercise heart rate from control, after exercise for 5 min at 70% of the subject's maximum work rate. 4 Atenolol 50 and 100 mg caused least bronchial beta‐adrenoceptor blockade and the greatest reduction in exercise heart rate. 5 Acebutolol 100 and 200 mg and labetalol 150 and 300 mg produced more bronchial beta‐adrenoceptor blockade than atenolol. 6 With this approach new beta‐adrenoceptor antagonists can be assessed without putting asthmatic patients at risk.

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“…It is possible in asthma to use a /3 2 -selective agonist (such as albuterol) in certain patients with concomitant low-dose /3,-selective blocker treatment. 44 In general, all /3-blockers should be avoided in patients with bronchospastic disease.…”

Section: Adverse Noncardiac Side Effects Related To £-Adrenergic Recementioning

confidence: 99%

Beta-adrenergic receptor blockers. Adverse effects and drug interactions.

Frishman

1988

Hypertension

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Adverse effects of beta-adrenergic receptor blocking drugs can be divided into two categories: 1) those that result from known pharmacological consequences of beta-adrenergic receptor blockade; and 2) other reactions that do not appear to result from beta-adrenergic receptor blockade. Adverse effects of the first type include bronchospasm, heart failure, prolonged hypoglycemia, bradycardia, heart block, intermittent claudication, and Raynaud's phenomenon. Neurological reactions include depression, fatigue, and nightmares. It is not yet proven whether the beta 1-selective adrenergic blockers or those with partial agonist activity reduce the overall frequency of adverse reactions seen with propranolol. Patient age does not appear, in itself, to be associated with more beta-blocker side effects. Side effects of the second category are rare. They include an unusual oculomucocutaneous reaction and the possibility of oncogenesis. There are also many drugs that interact with beta-blockers, which may increase toxicity. Finally, there are specific patient characteristics where one beta-blocker may be more effective and safer than another.

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A comparison of four beta‐adrenoceptor antagonists in patients with asthma.

Cited by 77 publications

References 4 publications

Assessment of airways, tremor and chronotropic responses to inhaled salbutamol in the quantification of beta 2‐adrenoceptor blockade.

Assessment of airways, tremor and chronotropic responses to inhaled salbutamol in the quantification of beta 2‐adrenoceptor blockade.

Bronchial and cardiac beta‐adrenoceptor blockade‐a comparison of atenolol, acebutolol and labetalol.

Beta-adrenergic receptor blockers. Adverse effects and drug interactions.

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