Beta-Adrenoceptor Blockers and Terbutaline in Patients with Chronic Obstructive Lung Disease

Wunderlich, John R.; Macha, H.-N.; Wudicke, H.; Huckauf, H.

doi:10.1378/chest.78.5.714

Cited by 22 publications

(11 citation statements)

References 13 publications

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“…Medical subject heading (MeSH) terms "respiratory tract diseases" and "adrenergic beta-antagonists" yielded 227 studies, 18 of which addressed the review objectives (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Key word searches "chronic obstructive lung disease" and "beta adrenergic receptor blocking agent" or "[beta-blocker name]" identified 2 further studies (23,24). These 20 studies matched the recent Cochrane library systematic review (25).…”

Section: Methodsmentioning

confidence: 99%

“…A Cochrane library meta-analysis concluded that long-term cardioselective beta-blockade is safe and well-tolerated in COPD (25,62). This meta-analysis evaluated pulmonary function in 20 randomized, controlled, crossover trials of cardioselective beta 1 -blockers in patients with COPD (Table 2) (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). No study included any patients with HF.…”

Section: Randomized Trials Of Cardioselective Beta-blockade In Copdmentioning

confidence: 99%

“…Only 2 studies involved more than 20 patients (15,23), some were only single-blinded (19,20), and others lacked placebo control (15,16,19,24). Eleven trials involved a single treatment dose, and only 1 lasted longer than a month (15).…”

Section: Randomized Trials Of Cardioselective Beta-blockade In Copdmentioning

confidence: 99%

“…However, the "long-term" results were derived from 2 studies that lasted just 1 week and recruited 16 patients (19,20). Inexplicably, the presented weighted mean difference (-3.11%) failed to incorporate 2 of the 6 referenced studies (18,23). In these, metoprolol reduced FEV 1 by 16% in 35 patients, whereas atenolol and metoprolol each significantly reduced FEV 1 by approximately 10% in 12 patients.…”

Section: Effect Of Cardioselective Beta-blockade On Severe Airflow Obmentioning

confidence: 99%

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Heart Failure and Chronic Obstructive Pulmonary Disease

Hawkins¹,

Petrie²,

MacDonald³

et al. 2011

Journal of the American College of Cardiology

130

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The combination of heart failure and chronic obstructive pulmonary disease presents many therapeutic challenges. The cornerstones of therapy are beta-blockers and beta-agonists, respectively. Their pharmacological effects are diametrically opposed, and each is purported to adversely affect the alternative condition. The tolerability of beta-blockade in patients with mild and fixed airflow obstruction likely extends to those with more severe disease. However, the evidence is rudimentary. The long-term influence of beta-blockade on pulmonary function, symptoms, and quality of life is unclear. Low-dose initiation and gradual up-titration of cardioselective beta-blockers is currently recommended. Robust clinical trials are needed to provide the answers that may finally allay physicians' mistrust of beta-blockers in patients with chronic obstructive pulmonary disease. Beta-agonists are associated with incident heart failure in patients with pulmonary disease and with increased mortality and hospitalization in those with existing heart failure. These purported adverse effects require further investigation. In the meantime, clinicians should consider carefully the etiology of dyspnea and obtain objective evidence of airflow obstruction before prescribing beta-agonists to patients with heart failure.

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Section: Methodsmentioning

confidence: 99%

Section: Randomized Trials Of Cardioselective Beta-blockade In Copdmentioning

confidence: 99%

Section: Randomized Trials Of Cardioselective Beta-blockade In Copdmentioning

confidence: 99%

Section: Effect Of Cardioselective Beta-blockade On Severe Airflow Obmentioning

confidence: 99%

See 2 more Smart Citations

Heart Failure and Chronic Obstructive Pulmonary Disease

Hawkins¹,

Petrie²,

MacDonald³

et al. 2011

Journal of the American College of Cardiology

130

View full text Add to dashboard Cite

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“…En un estudio de ese entonces, en un grupo de pacientes con enfermedad pulmonar obstructiva crónica y enfermedad coronaria o hipertensión, se observó un incremento en cuanto a obstrucción con el uso del metoprolol frente a placebo, pero en menor proporción que con el propranolol (34). Por esta razón, en la EPOC han sido subutilizados debido al temor de broncoconstricción y efectos adversos, sobre todo en las personas mayores.…”

Section: Beta-bloqueadores Y Enfermedad Pulmonar Obstructiva Crónicaunclassified

Uso de beta-bloqueadores en pacientes con enfermedad pulmonar obstructiva crónica

Osorio

2013

rev. colomb. neumol.

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Uso de beta-bloqueadores en pacientes con enfermedad pulmonar obstructiva crónicaUse of beta-blockers in patients with COPD RESUMEN La enfermedad pulmonar obstructiva crónica (EPOC) es un síndrome sistémico con múltiples fenotipos, en el que la enfermedad cardiovascular contribuye significativamente a la morbilidad y la mortalidad por su causa. El tabaquismo, la clase socioeconómica baja y un estilo de vida sedentario contribuyen a la historia natural de cada una de estas condiciones. La mayoría de las enfermedades cardiovasculares requieren tratamiento con beta-bloqueadores, que tradicionalmente se han contraindicado en los pacientes con EPOC; sin embargo el uso de estos fármacos se asocia a beneficios y mejores resultados en pacientes con enfermedades cardiovasculares, hipertensión, insuficiencia cardiaca, enfermedad coronaria y enfermedad pulmonar obstructiva crónica.Palabras clave: receptores adrenérgicos, beta-bloqueadores, enfermedad pulmonar obstructiva crónica, falla cardiaca. ABSTRACTChronic obstructive pulmonary disease (COPD) is a systemic syndrome with multiple phenotypes. Cardiovascular disease contributes significantly to the morbidity and mortality of COPD. Tobacco use, low socioeconomic class, and sedentary lifestyle contribute to the natural history of each of these conditions. Most cardiovascular diseases require treatment with beta-blockers. Traditionally, beta-blockers have been contraindicated in patients with COPD. However, the use of these drugs is associated with benefits and better results in patients with cardiovascular diseases, hypertension, heart failure, coronary disease, and COPD.

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