Abstract
1 Heart rate (HR) and blood pressure (BP) changes supine, at 60 degrees tilt and in response to increasing exercise loads, and HR responses to Valsalva's manoeuvre and to isoprenaline bolus injections were studied in 19 healthy volunteers to assess the response to abrupt withdrawal of atenolol n = 6, propranolol n = 6 and pindolol n = 7. 2 The dosage of each drug administered double-blind was gradually increased over a period of 2 weeks and the dose to produce maximum inhibition of exercise-induced tachycardia was continued for one further week. 3 Plasma renin activity, plasma noradrenaline and serum free thyroid hormones were measured during control periods, maximum dosage and withdrawal periods. 4 An increased sensitivity to isoprenaline injections was seen on Day 5 after withdrawal in the atenolol treated group whereas the pindolol treated group showed decreasing hyposensitivity to isoprenaline for the 13 days of observation after withdrawal and propranolol showed an intermediate effect. 5 There was no overshoot in HR or BP measurements at rest or in response to tilting, Valsalva's manoeuvre or exercise with atenolol or propranolol and with pindolol the HR response to tilt only was significantly higher on the third day post-drug. 6 Plasma noradrenaline and serum free T3 were reduced on drug treatment and further reduced in the early withdrawal period but there were no consistent changes in plasma renin activity.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Henry D. P., Starman B. J., Johnson D. G., Williams R. H. A sensitive radioenzymatic assay for norepinephrine in tissues and plasma. Life Sci. 1975 Feb 1;16(3):375–384. doi: 10.1016/0024-3205(75)90258-1. [DOI] [PubMed] [Google Scholar]
- Kristensen B. O., Steiness E., Weeke J. Propranolol withdrawal and thyroid hormones in patients with essential hypertension. Clin Pharmacol Ther. 1978 Jun;23(6):624–629. doi: 10.1002/cpt1978236624. [DOI] [PubMed] [Google Scholar]
- Nattel S., Rangno R. E., Van Loon G. Mechanism of propranolol withdrawal phenomena. Circulation. 1979 Jun;59(6):1158–1164. doi: 10.1161/01.cir.59.6.1158. [DOI] [PubMed] [Google Scholar]
- Prichard B. N., Walden R. J. The syndrome associated with the withdrawal of beta-adrenergic receptor blocking drugs. Br J Clin Pharmacol. 1982;13(Suppl 2):337S–343S. doi: 10.1111/j.1365-2125.1982.tb01938.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- ROSE G. A., HOLLAND W. W., CROWLEY E. A. A SPHYGMOMANOMETER FOR EPIDEMIOLOGISTS. Lancet. 1964 Feb 8;1(7328):296–300. doi: 10.1016/s0140-6736(64)92408-0. [DOI] [PubMed] [Google Scholar]
- Romelli P. B., Pennisi F., Vancheri L. Measurement of free thyroid hormones in serum by column adsorption chromatography and radioimmunoassay. J Endocrinol Invest. 1979 Jan-Mar;2(1):25–40. doi: 10.1007/BF03349272. [DOI] [PubMed] [Google Scholar]
- Ross P. J., Lewis M. J., Sheridan D. J., Henderson A. H. Adrenergic hypersensitivity after beta-blocker withdrawal. Br Heart J. 1981 Jun;45(6):637–642. doi: 10.1136/hrt.45.6.637. [DOI] [PMC free article] [PubMed] [Google Scholar]