Pharmacology of Combined α-β-Blockade II

@article{Lundjohansen2012PharmacologyOC,
  title={Pharmacology of Combined $\alpha$-$\beta$-Blockade II},
  author={P. Lund-johansen},
  journal={Drugs},
  year={2012},
  volume={28},
  pages={35-50}
}
SummaryThe cardinal haemodynamic disturbance in established hypertension is an increased total peripheral resistance and a subnormal blood flow, particularly during exercise. The spontaneously occurring changes in central haemodynamics have been followed in young males with essential hypertension over a 17-year period: a gradual increase in total peripheral resistance and blood pressure, and a gradual fall in cardiac output and stroke volume, have been demonstrated.Labetalol is a unique… 

Combined α- and β-Receptor Inhibition in the Treatment of Hypertension

The combination of α- with β-adrenoceptor blockade represents a useful addition to the drugs available for the treatment of hypertension, and labetalol is used in all grades of hypertension alone or in combination with other antihypertensives when required.

Progress in Antihypertensive Therapy with a Multiple-Action Drug

The mode of antihypertensive action of β-blockade remains unclear, as does the exact contribution of the 3 mechanisms of peripheral vasodilatation, but the combination of pharmacological effects represents an additional means of lowering blood pressure.

Drug Treatment of Hypertension

More severe cases of hypertension may require drugs from 2 of the 3 major groups: β-blocking drugs, vasodilators and diuretics, and in some cases, drugs from each of these 3 groups will be required.

Current Drug Treatment and Treatment Patterns with Antihypertensive Drugs

The 4 major classes of antihypertensive drugs are diuretics, β-blockers, ACE inhibitors and calcium antagonists, and they are the most effective drugs for use in combination therapy.

Clevidipine: A Short‐Acting Intravenous Dihydropyridine Calcium Channel Blocker for the Management of Hypertension

The lack of specific clinical outcomes documenting improved morbidity and mortality rates as compared with other agents, the small numbers of treated patients, and concerns regarding the lipid formulation necessitate further investigation to help define the therapeutic role of clevidipine.

Treatment of Acute Severe Hypertension

Patients with hypertensive emergencies are best treated in an intensive care unit with titratable, intravenous, hypotensive agents, including labetalol, esmolol, fenoldopam, nicardipine and sodium nitroprusside.

Pharmacological Management of Hypertension in Paediatric Patients

The current drug classes are reviewed with respect to dosage guidelines, adverse effects and potential drug-drug interactions, and the advantages and disadvantages of a tailored or individualised therapeutic approach as opposed to rigid stepped care therapy are presented.

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The reflex tachycardia and overshoot of BP in Valsalva's manoeuvre were largely abolished and central and peripheral venous BPs, vascular volume of the forearm and venous distensibility did not show any significant change after treatment with labetalol.

Haemodynamic effects and plasma concentrations of labetalol during long-term treatment of essential hypertension.

The haemodynamic changes differ from those seen after long-term therapy with drugs possessing only β-adrenoceptor blocking properties, and agree well with what should be expected with a drug which possesses both α- and β-adsenergic receptor blocking properties.

Acute and long-term effects of labetalol on systemic and pulmonary haemodynamics in hypertensive patients

The haemodynamic patterns after acute and long-term administration of labetalol were essentially similar, which suggests that the agent is suitable both for acute andlong-term treatment of hypertension, at least from a haemodynamics point of view.

Response of the systemic and pulmonary circulation to alpha- and beta-receptor blockade (labetalol) at rest and during exercise in hypertensive patients.

Hemodynamic observations suggest that the antihypertensive action of L is based mainly on its f-receptor blocking properties at RR, and on both its aand f- receptor blocking effects sitting and at exercise.

Prizidilol in Essential Hypertension: Long‐Term Effects on Plasma Volume, Extracellular Fluid Volume, and Central Hemodynamics at Rest and During Exercise

It is concluded that, in mild and moderate EH, prizidilol induces a substantial fall in BP with an excellent hemodynamic profile both at rest and during exercise.

Response of the systemic pulmonary circulation to labetalol at rest and during exercise.

The drug produced significant decreases in plasma renin activity and in plasma aldosterone concentration, and reduced mean pulmonary arterial and capillary wedge pressures only in the sitting position.

Hemodynamic Effects of Labetalol, an Alpha and Beta Adrenergic Blocking Agent, in Hypertensive Subjects

It is indicated that labetalol is an antihypertensive drug that exerts both alpha and beta adrenergic blocking properties and deserves further clinical trials in the treatment of hypertension and angina pectoris.
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