THE EFFECT OF D‐ VERSUS L‐ PROPRANOLOL IN THE TREATMENT OF HYPERTHYROIDISM

@article{Eber1990THEEO,
  title={THE EFFECT OF D‐ VERSUS L‐ PROPRANOLOL IN THE TREATMENT OF HYPERTHYROIDISM},
  author={Otto Eber and Wolfgang Buchinger and Wolfgang Lindner and PETER, MONIKA LIND RATH and G. Klima and Werner Langsteger and Peter Koltringer},
  journal={Clinical Endocrinology},
  year={1990},
  volume={32}
}
The purpose of this study is to determine whether there is a difference in treatment of hyperthyroidism using either the D‐ or L‐isomer of propranolol. Two groups of 20 patients with overt hyperthyroidism received either 120 mg L‐or D‐propranolol each for a period of 5 days. In the D‐propranolol administered group there was a significant decrease in TT3 and f T3 plasma levels and in the ratio of TT3 to TT4; however, a significant increase occurred in rT3 values up to day 5. On the other hand, L… 

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Effect of propranolol on extrathyroidal metabolism of thyroxine and 3,3',5-triiodothyronine evaluated by noncompartmental kinetics.

TLDR
Kinetic studies of T4 and T3 using a noncompartmental approach were performed in patients with pretreatment severe hypothyroidism maintained on L-T4 replacement, indicating a reduced extrathyroidal conversion of T 4 to T3 during propranolol treatment.

The influence of propranolol on the extrathyroidal metabolism of 3,3',5'-triiodothyronine (reverse T3).

TLDR
The results are compatible with the assumption of two different monodeiodinating enzymes, a 5-deiodinase responsible for the diodination of T4 to rT3 and a 5'-deiod inase responsiblefor the deiodinated version of T3 to T3.

The effect of D,L-4-hydroxypropranolol on the thyroxine to 3,5,3'-triiodothyronine conversion in rat renal and liver microsomes.

TLDR
It is concluded, that the metabolite D,L-4-OH-propranolol is a much more potent and efficacious inhibitor of the T4-5'-deiodination than D, L-pro Pranolol.

Comparative trial of atenolol and propranolol in hyperthyroidism.

TLDR
Judged by their effect on the symptoms and signs of hyperthyroidism, both atenolol and propranolol were significantly better than placebo, but no distinction could be made between the two active compounds.

THE EFFECT OF ATENOLOL ON SERUM THYROID HORMONES IN HYPERTHYROID PATIENTS

TLDR
The data do not support the hypothesis that the beneficial clinical effects of β‐adrenoceptor blocking drugs in thyrotoxicosis are mediated by an action on the peripheral metabolism of thyroid hormones.

Three-compartmental analysis of effects of D-propranolol on thyroid hormone kinetics.

Tracer thyroxine (T4), 3.3',5-triiodothyronine (T3), and 3,3',5'-triiodothyronine (rT3) kinetic studies were performed in normal T4 substituted subjects before and during oral D-propranolol treatment

Inhibition by propranolol of 3,5,3'-triiodothyronine formation from thyroxine in isolated rat renal tubules: an effect independent of beta-adrenergic blockade.

TLDR
It is concluded that DL-propranolol directly inhibits net T3 formation from T4 in this system by a direct membrane-stabilizing or quinidine-like action and not by specific beta-blockade.

Non-selective and selective beta-1-adrenoceptor blocking agents in the treatment of hyperthyroidism.

TLDR
The improvement of the clinical symptoms of hyperthyroidism cannot be explained by diminished thyroid hormone concentrations in serum, since the reduction was small during propranolol and absent during atenolol treatment.

Comparison of propranolol and practolol in the management of hyperthyroidism.

TLDR
To be sure of the efficacy of practoloo, further trials in hyperthyroid patients of newer beta1-adrenoceptor antagonists, preferably without partial agonist activity, are indicated.

Stereoselective clearance and distribution of intravenous propranolol

TLDR
It is demonstrated that multiple stereoselective mechanisms are involved in the disposition of propranolol and determine the access of the drug to active sites and the higher Cls of (+)‐pro Pranolol suggests stereoselected hepatic elimination.