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. 1982;13(Suppl 2):325S–335S. doi: 10.1111/j.1365-2125.1982.tb01937.x

Assessment of beta-adrenoceptor antagonists in asthmatic patients.

R E Ruffin, E L McIntyre, K M Latimer, H E Ward, A J Crockett, J H Alpers
PMCID: PMC1402141  PMID: 6125185

Abstract

1 Bronchial smooth muscle, skeletal muscle and cardiac beta-adrenoceptor antagonism have been compared in twelve asthmatic patients after three beta-adrenoceptor antagonists at two dose levels. The non-selective antagonist propranolol (40 and 160 mg), the non-selective antagonist with partial agonist activity pindolol (5 and 20 mg) and the beta 1-selective antagonist atenolol (50 and 200 mg) were studied on separate occasions. 2 Six placebo days were used in this double-blind crossover study to allow interpretation of individual as well as group results. 3 Bronchial smooth muscle effects were assessed by resting spirometry, histamine inhalation test and spirometric response to inhaled fenoterol. Skeletal muscle effects were assessed by resting tremor and fenoterol induced tremor. 4 Cardiac beta-adrenoceptor antagonism was assessed by measuring the effect on resting heart rate and on maximum heart rate in a standard exercise test. 5 Pindolol tended to cause least change from placebo in resting spirometry, caused significant tremor response, inhibited the fenoterol airway response, and tended to protect against inhaled histamine. 6 Atenolol 60 mg was the only drug to allow a fenoterol airway response similar to placebo. Atenolol increased the inhaled histamine responsiveness. 7 Propranolol 160 mg caused the most reduction in spirometry but also tended to cause the maximum reduction in exercise heart rate. Propranolol caused increased inhaled histamine responsiveness. 8 Initial sensitivity to inhaled histamine did not necessarily predict significant reduction in an asthmatics' spirometry by a beta-adrenoceptor antagonist. The effect of a beta-adrenoceptor antagonist on histamine responsiveness does not correspond to its effect on inhaled beta 2-adrenoceptor agonist responsiveness.

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Selected References

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  1. Bangah M., Jackman G., Bobik A. Determination of pindolol in human plasma by high-performance liquid chromatography. J Chromatogr. 1980 Aug 8;183(2):255–259. doi: 10.1016/s0378-4347(00)81703-x. [DOI] [PubMed] [Google Scholar]
  2. Benson M. K., Berrill W. T., Sterling G. M., Decalmer P. B., Chatterjee S. S., Croxson R. S., Cruickshank J. M. Cardioselective and non-cardioselective beta-blockers in reversible obstructive airways disease. Postgrad Med J. 1977;53 (Suppl 3):143–148. [PubMed] [Google Scholar]
  3. Beumer H. M., Teirlinck C., Wiseman R. A. Comparative investigation of the respiratory and cardiovascular effect of mepindolol, propranolol and pindolol in asthmatic patients. Int J Clin Pharmacol Biopharm. 1978 Jun;16(6):249–253. [PubMed] [Google Scholar]
  4. Casterline C. L., Evans R., 3rd, Ward G. W., Jr The effect of atropine and albuterol aerosols on the human bronchial response to histamine. J Allergy Clin Immunol. 1976 Nov;58(5):607–613. doi: 10.1016/0091-6749(76)90207-4. [DOI] [PubMed] [Google Scholar]
  5. Casterline C. L., Evans R. Further studies on the mechanism of human histamine-induced asthma: the effect of an aerosolized H1 receptor antagonist (diphenhydramine). J Allergy Clin Immunol. 1977 Jun;59(6):420–424. doi: 10.1016/0091-6749(77)90004-5. [DOI] [PubMed] [Google Scholar]
  6. Christensen C. C., Boye N. P., Erikson H., Hansen G. Influence of pindolol (Visken) on respiratory function in 20 asthmatic patients. Eur J Clin Pharmacol. 1978 Mar 17;13(1):9–12. doi: 10.1007/BF00606674. [DOI] [PubMed] [Google Scholar]
  7. Cockcroft D. W., Killian D. N., Mellon J. J., Hargreave F. E. Bronchial reactivity to inhaled histamine: a method and clinical survey. Clin Allergy. 1977 May;7(3):235–243. doi: 10.1111/j.1365-2222.1977.tb01448.x. [DOI] [PubMed] [Google Scholar]
  8. Connolly C. K., Batten J. C. Comparison of the effect of alprenolol and propranolol on specific airway conductance in asthmatic subjects. Br Med J. 1970 May 30;2(5708):515–516. doi: 10.1136/bmj.2.5708.515. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Decalmer P. B., Chatterjee S. S., Cruickshank J. M., Benson M. K., Sterling G. M. Beta-blockers and asthma. Br Heart J. 1978 Feb;40(2):184–189. doi: 10.1136/hrt.40.2.184. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Frishman W., Davis R., Strom J., Elkayam U., Stampfer M., Ribner H., Weinstein J., Sonnenblick E. Clinical pharmacology of the new beta-adrenergic blocking drugs. Part 5. Pindolol (LB-46) therapy for supraventricular arrhythmia: a viable alternative to propranolol in patients with bronchospasm. Am Heart J. 1979 Sep;98(3):393–398. doi: 10.1016/0002-8703(79)90053-x. [DOI] [PubMed] [Google Scholar]
  11. Lees G. M. A hitch-hiker's guide to the galaxy of adrenoceptors. Br Med J (Clin Res Ed) 1981 Jul 18;283(6285):173–178. doi: 10.1136/bmj.283.6285.173. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. MCNEILL R. S. EFFECT OF A BETA-ADRENERGIC-BLOCKING AGENT, PROPRANOLOL, ON ASTHMATICS. Lancet. 1964 Nov 21;2(7369):1101–1102. doi: 10.1016/s0140-6736(64)92617-0. [DOI] [PubMed] [Google Scholar]
  13. Mattson K., Poppius H. Controlled study of the bronchoconstriction effect of pindolol administered intravenously or orally to patients with unstable asthma. Eur J Clin Pharmacol. 1978 Nov 16;14(2):87–92. doi: 10.1007/BF00607436. [DOI] [PubMed] [Google Scholar]
  14. McDevitt D. G. beta-Adrenoceptor antagonists and respiratory function. Br J Clin Pharmacol. 1978 Feb;5(2):97–99. doi: 10.1111/j.1365-2125.1978.tb01607.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. McLean A. J., Skews H., Bobik A., Dudley F. J. Interaction between oral propranolol and hydralazine. Clin Pharmacol Ther. 1980 Jun;27(6):726–732. doi: 10.1038/clpt.1980.103. [DOI] [PubMed] [Google Scholar]
  16. Morris J. F., Koski A., Johnson L. C. Spirometric standards for healthy nonsmoking adults. Am Rev Respir Dis. 1971 Jan;103(1):57–67. doi: 10.1164/arrd.1971.103.1.57. [DOI] [PubMed] [Google Scholar]
  17. Perks W. H., Chatterjee S. S., Croxson R. S., Cruickshank J. M. Comparison of atenolol and oxprenolol in patients with angina or hypertension and co-existent chronic airways obstruction. Br J Clin Pharmacol. 1978 Feb;5(2):101–106. doi: 10.1111/j.1365-2125.1978.tb01608.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Ruffin R. E., Frith P. A., Anderton R. C., Kumana C. R., Newhouse M. T., Hargreave F. E. Selectivity of beta adrenoreceptor antagonist drugs assessed by histamine bronchial provocation. Clin Pharmacol Ther. 1979 May;25(5 Pt 1):536–540. doi: 10.1002/cpt1979255part1536. [DOI] [PubMed] [Google Scholar]
  19. Ruffin R. E., Montgomery J. M., Newhouse M. T. Aerosol fenoterol by intermittent positive pressure breathing in asthmatic patients. Clin Pharmacol Ther. 1979 Jun;25(6):821–825. doi: 10.1002/cpt1979256821. [DOI] [PubMed] [Google Scholar]
  20. Ryo U. Y., Townley R. G. Comparison of respiratory and cardiovascular effects of isoproterenol, propranolol, and practolol in asthmatic and normal subjects. J Allergy Clin Immunol. 1976 Jan;57(1):12–24. doi: 10.1016/0091-6749(76)90074-9. [DOI] [PubMed] [Google Scholar]
  21. Singh B. N., Whitlock R. M., Comber R. H., Williams F. H., Harris E. A. Effects of cardioselective beta adrenoceptor blockade on specific airways resistance in normal subjects and in patients with bronchial asthma. Clin Pharmacol Ther. 1976 May;19(5 Pt 1):493–501. doi: 10.1002/cpt1976195part1493. [DOI] [PubMed] [Google Scholar]
  22. Skinner C., Gaddie J., Palmer K. N. Comparison of effects of metoprolol and propranolol on asthmatic airway obstruction. Br Med J. 1976 Feb 28;1(6008):504–504. doi: 10.1136/bmj.1.6008.504. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Weddle O. H., Amick E. N., Mason W. D. Rapid determination of atenolol in human plasma and urine by high-pressure liquid chromatography. J Pharm Sci. 1978 Jul;67(7):1033–1035. doi: 10.1002/jps.2600670748. [DOI] [PubMed] [Google Scholar]
  24. Zaid G., Beall G. N. Bronchial response to beta-adrenergic blockade. N Engl J Med. 1966 Sep 15;275(11):580–584. doi: 10.1056/NEJM196609152751103. [DOI] [PubMed] [Google Scholar]

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