Observations in Man of Hypoglycaemia during Selective and Non-Selective Beta-Blockade

Nm, Davidson; Rj, Corrall; Tr, Shaw; Eb, French

doi:10.1177/003693307702200117

Cited by 63 publications

(15 citation statements)

References 9 publications

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“…Our cardiovascular findings corroborate those of previous studies (Davidson et al, 1977;Lager et al, 1979;Lloyd-Mostyn & Oram, 1975). The decreased pulse rates, during hypoglycaemia, whilst the subjects were taking propranolol or atenolol, suggests that their ,3-adrenoceptors were well blocked at the time of study.…”

Section: Discussionsupporting

confidence: 91%

The effect of selective and non‐selective beta‐adrenoceptor blockade, and of naloxone infusion, on the hormonal mechanisms of recovery from insulin‐induced hypoglycaemia in man.

Armitstead¹,

Lightman²,

Brown³

et al. 1983

Brit J Clinical Pharma

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The rise in plasma adenosine-3',5'-monophosphate occurring in response to insulin induced hypoglycaemia in normal human subjects, was abolished by non-selective ,3-adrenoceptor blockade but unaffected by selective (31-adrenoceptor blockade. This implies that the rise is secondary to /2-adrenoceptor stimulation. The abolition of this rise by non-selective f3-adrenoceptor blockade had no pronounced effect on the recovery from hypoglycaemia. Endogenous opiate receptor blockade with naloxone had no significant effect on the recovery from insulin induced hypoglycaemia, or the hormonal mechanisms involved.

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Section: Discussionsupporting

confidence: 91%

The effect of selective and non‐selective beta‐adrenoceptor blockade, and of naloxone infusion, on the hormonal mechanisms of recovery from insulin‐induced hypoglycaemia in man.

Armitstead¹,

Lightman²,

Brown³

et al. 1983

Brit J Clinical Pharma

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“…Then, unopposed a-adrenoceptor stimulation from adrenaline release results in a marked diastolic pressor effect, which triggers a bradycardia via the baroreceptors (Davidson et al, 1976).…”

Section: Discussionmentioning

confidence: 99%

Pharmacodynamic profile of bisoprolol, a new beta 1‐selective adrenoceptor antagonist.

Léopold¹,

Ungethüm²,

Pabst³

et al. 1986

Brit J Clinical Pharma

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The pharmacodynamic profile of bisoprolol, a new beta 1‐selective adrenoceptor antagonist, was investigated in four independent studies including 36 healthy male volunteers. Using the model of exercise‐ induced tachycardia (ET) the beta‐adrenoceptor blocking properties of bisoprolol (2.5‐40 mg) were examined in comparison to metoprolol (50 and 100 mg), propranolol (40 and 80 mg) and atenolol (50 and 100 mg). The maximal reduction of ET was achieved between 1 and 4 h following single oral administration. The dose‐response relationship using individual maximal reduction of ET showed, on a molar basis, that bisoprolol is about 5, 7 and 10 times more effective than propranolol, atenolol and metoprolol, respectively. In the model of insulin‐induced hypoglycaemia bisoprolol behaved as a beta 1‐selective adrenoceptor antagonist. There was a good correlation (r = 0.94) between the log bisoprolol concentration and the reduction in exercise‐induced tachycardia. Bisoprolol is a potent new cardioselective beta‐ adrenoceptor antagonist with a competitive action at beta 1‐ adrenoceptors.

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“…It has been suggested that the use of selective P-blockers may circumvent this problem [10]. However, reports on the effects of propranolol and metoprolol on glucose metabolism during insulin-induced hypogly cemia have been contradictory [11][12][13][14] and no study in hemodialysis patients has been reported.…”

Section: Introductionmentioning

confidence: 99%

Effects of Propranolol and Metoprolol on Glucose, Cyclic AMP and Insulin Responses during Pharmacologic Hyperglucagonemia in Hemodialysis Patients

Pun¹,

Yeung²,

Yeung³

1985

Nephron

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Propranolol-induced hypoglycemia in hemodialysis patients has been increasingly recognized. We studied the effects of a nonselective β-blocker (propranolol) and a β₁-selective-blocker (metoprolol) on glucose metabolism during pharmacologic hyperglucagonemia in these patients. cAMP and insulin responses to glucagon were noted to be significantly higher in all patients after dialysis. This may possibly be due to the removal of a dialyzable factor suppressing these responses. However, despite a similar cAMP response, patients on propranolol had significantly lower glucose response than those not receiving β-blocker before and after dialysis. While patients on metoprolol also had impaired glucose response before dialysis, this significantly improved after dialysis possibly due to the removal of active metabolite(s). Results suggest that metoprolol has less interference on glucose response to glucagon than propranolol in hemodialysis.

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Observations in Man of Hypoglycaemia during Selective and Non-Selective Beta-Blockade

Cited by 63 publications

References 9 publications

The effect of selective and non‐selective beta‐adrenoceptor blockade, and of naloxone infusion, on the hormonal mechanisms of recovery from insulin‐induced hypoglycaemia in man.

The effect of selective and non‐selective beta‐adrenoceptor blockade, and of naloxone infusion, on the hormonal mechanisms of recovery from insulin‐induced hypoglycaemia in man.

Pharmacodynamic profile of bisoprolol, a new beta 1‐selective adrenoceptor antagonist.

Effects of Propranolol and Metoprolol on Glucose, Cyclic AMP and Insulin Responses during Pharmacologic Hyperglucagonemia in Hemodialysis Patients

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