Mechanisms of landiolol-mediated positive inotropy in critical care settings

Chalkias, Athanasios; O’Donnell, E. Paul

doi:10.1007/s00228-023-03584-3

Cited by 2 publications

(2 citation statements)

References 44 publications

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“…The activation of β-1 receptors leads to an increase in intracellular calcium levels through several mechanisms, including enhanced calcium release from the sarcoplasmic reticulum and increased calcium entry through L-type calcium channels in the cell membrane. The increase in intracellular calcium levels and the subsequent activation of PKA through the ryanodine receptor 2, sarcoplasmic/endoplasmic reticulum calcium ATPase 2 and phospholamban lead to enhanced contractility and increased HR in cardiac myocytes [3,13,17,23]. When β-blockers like landiolol block β-1 receptors, they interfere with all of these intracellular signaling pathways.…”

Section: Overview Of Pharmacodynamics and Pharmacokinetics In Compari...mentioning

confidence: 99%

An Overview of the Pharmacokinetics and Pharmacodynamics of Landiolol (an Ultra-Short Acting β1 Selective Antagonist) in Atrial Fibrillation

Floria,

Oancea,

Morariu

et al. 2024

Pharmaceutics

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Landiolol is an ultra-short-acting, selective β1-adrenergic receptor blocker that was originally approved in Japan for the treatment of intraoperative tachyarrhythmias. It has gained attention for its use in the management of tachyarrhythmias and perioperative tachycardia, especially atrial fibrillation for both cardiac and non-cardiac surgeries. It can be the ideal agent for heart rate control due to its high β1-selectivity, potent negative chronotropic effect, a limited negative inotropic potential, and an ultrashort elimination half-life (around 4 min); moreover, it may have a potential therapeutic effects for sepsis and pediatric patients. Landiolol seems to be superior to other short-acting and selective beta-blockers such as esmolol. This review aims to provide a comprehensive overview of landiolol, a new ultra-short-acting β1 selective antagonist, including its pharmacology, clinical applications, efficacy, safety profile, and future directions in research and clinical data.

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Section: Overview Of Pharmacodynamics and Pharmacokinetics In Compari...mentioning

confidence: 99%

An Overview of the Pharmacokinetics and Pharmacodynamics of Landiolol (an Ultra-Short Acting β1 Selective Antagonist) in Atrial Fibrillation

Floria,

Oancea,

Morariu

et al. 2024

Pharmaceutics

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show abstract

“…The advantage of Landiolol is considered to be its significantly higher cardioselectivity, which leads to significantly less negative inotropy and, thus, significantly less hypotension, which is an important safety aspect, especially in emergency medicine and critical care [ 5 ]. Some studies even describe an improvement in inotropy with Landiolol [ 6 ]. Landiolol is available both for continuous administration and as a bolus medication.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Chronic Oral Beta-Blocker Intake on Intravenous Bolus Landiolol Response in Hospitalized Intensive Care Patients with Sudden-Onset Supraventricular Tachycardia—A Post Hoc Analysis of a Cross-Sectional Trial

Eibensteiner,

Mosor,

Tihanyi

et al. 2024

Pharmaceutics

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Background: Landiolol, a highly cardioselective agent with a short half-life (2.4–4 min), is commonly used as a perfusor or bolus application to treat tachycardic arrhythmia. Some small studies suggest that prior oral β-blocker use results in a less effective response to intravenous β-blockers. Methods: This study investigated whether prior chronic oral β-blocker (Lβ) or no prior chronic oral β-blocker (L–) intake influences the response to intravenous push-dose Landiolol in intensive care patients with acute tachycardic arrhythmia. Results: The effects in 30 patients (67 [55–72] years) were analyzed, 10 (33.3%) with and 20 (66.7%) without prior oral β-blocker therapy. Arrhythmias were diagnosed as tachycardic atrial fibrillation in 14 patients and regular, non-fluid-dependent, supraventricular tachycardia in 16 cases. Successful heart rate control (Lβ 4 vs. L– 7, p = 1.00) and rhythm control (Lβ 3 vs. L– 6, p = 1.00) did not significantly differ between the two groups. Both groups showed a significant decrease in heart rate when comparing before and after the bolus administration, without significant differences between the two groups (Lβ −26/min vs. L– −33/min, p = 0.528). Oral β-blocker therapy also did not influence the change in mean arterial blood pressure after Landiolol bolus administration (Lβ −5 mmHg vs. L– −4 mmHg, p = 0.761). Conclusions: A prior chronic intake of β-blockers neither affected the effectiveness of push-dose Landiolol in heart rate or rhythm control nor impacted the difference in heart rate or mean arterial blood pressure before and after the Landiolol boli.

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Mechanisms of landiolol-mediated positive inotropy in critical care settings

Cited by 2 publications

References 44 publications

An Overview of the Pharmacokinetics and Pharmacodynamics of Landiolol (an Ultra-Short Acting β1 Selective Antagonist) in Atrial Fibrillation

An Overview of the Pharmacokinetics and Pharmacodynamics of Landiolol (an Ultra-Short Acting β1 Selective Antagonist) in Atrial Fibrillation

The Impact of Chronic Oral Beta-Blocker Intake on Intravenous Bolus Landiolol Response in Hospitalized Intensive Care Patients with Sudden-Onset Supraventricular Tachycardia—A Post Hoc Analysis of a Cross-Sectional Trial

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