Clinical differences between beta-adrenergic blocking agents: implications for therapeutic substitution

American Heart Journal
W H Frishman

Abstract

The beta blockers exhibit clinically significant differences in beta-receptor selectivity, intrinsic sympathomimetic activity, and alpha-adrenergic blocking activity. These agents also show important differences in their pharmacokinetic profiles, including gastrointestinal absorption, first-pass hepatic metabolism, lipid solubility, protein binding, hepatic biotransformation, pharmacologic activity of metabolites, and renal clearance of unchanged drug and metabolites. These many differences determine the appropriateness of administering a given beta blocker in a given clinical situation. The selection of beta blockers must also take into account concurrent therapy with other agents. Concurrent administration of beta blockers with drugs that alter gastric, hepatic, or renal function may affect blood levels, duration of action, or efficacy of beta-blocker action. The beta blockers vary in the extent to which their action is altered when they are given with other agents, and therapeutic substitution may produce unwanted side effects and toxicity. Elderly patients should be carefully monitored following interchange among beta blockers, since the probability of drug interaction, impact of adverse effects, unpredictability of respons...Continue Reading

References

Apr 17, 1976·British Medical Journal·R R Bailey, T J Neale
Jan 1, 1976·Drugs·G Johnsson, C G Regàrdh
Nov 1, 1976·Progress in Cardiovascular Diseases·M E ConollyC T Dollery
Dec 1, 1976·Drugs·H J Waal-Manning
Jan 1, 1976·Clinical Pharmacokinetics·G Johnsson, C G Regàrdh
Apr 28, 1979·British Medical Journal·D A Jackson
Jan 1, 1979·British Journal of Clinical Pharmacology·N K HollenbergJ M Sullivan
Sep 27, 1979·The New England Journal of Medicine·J Koch-Weser
Mar 1, 1979·Clinical Pharmacokinetics·P A Routledge, D G Shand
Jan 1, 1979·European Journal of Clinical Pharmacology·H HalkinB Rabinowitz
Mar 3, 1979·British Medical Journal·R Wilkinson
Jul 1, 1979·Anesthesiology·D L BruceJ S Lee
Jan 1, 1979·British Journal of Clinical Pharmacology·C M Castleden, C F George
Mar 1, 1985·Progress in Cardiovascular Diseases·S YusufP Sleight
Nov 21, 1985·The New England Journal of Medicine·J E MullerT Robertson
Apr 25, 1986·The American Journal of Cardiology·J L ReidA D Struthers
Jul 5, 1985·The Medical Letter on Drugs and Therapeutics
Jan 1, 1985·Social Science & Medicine·J Lilja
Sep 11, 1971·British Medical Journal·K O'MalleyI H Stevenson
Mar 29, 1980·Lancet·L H Opie
Aug 27, 1981·The New England Journal of Medicine·J Koch-Weser, W H Frishman
Sep 17, 1981·The New England Journal of Medicine·W H Frishman
Jan 1, 1982·British Journal of Clinical Pharmacology·J F Giudicelli, F Lhoste
Jan 1, 1982·British Journal of Clinical Pharmacology·W J Louis, J J McNeil
Jan 1, 1982·International Journal of Cardiology·W H Frishman
Jun 1, 1983·Journal of Clinical and Hospital Pharmacy·R Vogel
Mar 29, 1984·The New England Journal of Medicine·W H FrishmanW T Friedewald
Jun 1, 1984·Current Problems in Cardiology·W H FrishmanW T Friedewald
Sep 6, 1984·The New England Journal of Medicine
Apr 21, 1983·The New England Journal of Medicine·W H Frishman
Jul 1, 1983·MMW, Münchener medizinische Wochenschrift·G Riecker
Nov 1, 1984·British Journal of Clinical Pharmacology·J W Paxton, R H Briant
Nov 1, 1983·The American Journal of Cardiology·G V HellerJ M Aroesty
Feb 1, 1983·Clinical Cardiology·T SantosoN Abdurahman
Mar 1, 1981·Progress in Cardiovascular Diseases·M C Houston
Mar 26, 1982·JAMA : the Journal of the American Medical Association
Jun 17, 1982·The New England Journal of Medicine·W H Frishman
Jun 1, 1982·Southern Medical Journal·M C Houston
Feb 1, 1974·British Journal of Clinical Pharmacology·R E IrvineJ R Trounce

Citations

Jul 3, 1999·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·S TakahashiH Toyooka
Mar 24, 2000·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·S TakahashiH Toyooka
Oct 12, 2011·Journal of Veterinary Pharmacology and Therapeutics·K H KhorP C Mills
Apr 1, 1989·The American Journal of Cardiology·W H FrishmanA Stevenson
Mar 1, 1989·American Heart Journal·W C Roberts
Mar 1, 1989·Neurophysiologie clinique = Clinical neurophysiology·A D Kazis
May 3, 2013·Journal of Cardiovascular Pharmacology and Therapeutics·W H Frishman
Jul 9, 2020·Chemistry : a European Journal·Xuekang CaiGuanshu Liu
May 1, 1989·Postgraduate Medicine·J R Buechler, W Malloy
Sep 1, 1991·DICP : the Annals of Pharmacotherapy·T T Sproat, L M Lopez
Jan 15, 1990·The Medical Journal of Australia·P R Pentel, D M Salerno

Related Concepts

Adrenergic beta-Antagonists
Heart Diseases

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Alzheimer's Disease: MS4A

Variants within the membrane-spanning 4-domains subfamily A (MS4A) gene cluster have recently been implicated in Alzheimer's disease in genome-wide association studies. Here is the latest research on Alzheimer's disease and MS4A.

Pediculosis pubis

Pediculosis pubis is a disease caused by a parasitic insect known as Pthirus pubis, which infests human pubic hair, as well as other areas with hair including eye lashes. Here is the latest research.

Rh Isoimmunization

Rh isoimmunization is a potentially preventable condition that occasionally is associated with significant perinatal morbidity or mortality. Discover the latest research on Rh Isoimmunization here.

Genetic Screens in iPSC-derived Brain Cells

Genetic screening is a critical tool that can be employed to define and understand gene function and interaction. This feed focuses on genetic screens conducted using induced pluripotent stem cell (iPSC)-derived brain cells. It also follows CRISPR-Cas9 approaches to generating genetic mutants as a means of understanding the effect of genetics on phenotype.

Enzyme Evolution

This feed focuses on molecular models of enzyme evolution and new approaches (such as adaptive laboratory evolution) to metabolic engineering of microorganisms. Here is the latest research.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Pharmacology of Proteinopathies

This feed focuses on the pharmacology of proteinopathies - diseases in which proteins abnormally aggregate (i.e. Alzheimer’s, Parkinson’s, etc.). Discover the latest research in this field with this feed.

Alignment-free Sequence Analysis Tools

Alignment-free sequence analyses have been applied to problems ranging from whole-genome phylogeny to the classification of protein families, identification of horizontally transferred genes, and detection of recombined sequences. Here is the latest research.