Optimal features of a new beta-blocker.

Abstract:

:Therapeutics involves the careful balance between treatment disadvantages and advantages--the so-called risk-benefit ratio. Even after 20 years beta-blockers must be selected carefully to suit the patient's needs. This review examines several problems associated with beta-blockade. Generally, beta1-cardioselectivity is considered advantageous, but properties such as partial agonist activity, which limits receptor up-regulation, might be of greater value in reducing the adverse effects associated with abrupt drug withdrawal. Beta-Blockers, either lipophilic or hydrophilic agents, have specific problems: lipophilic drugs provoke adverse central nervous system effects and need careful dose titration; variable gastrointestinal absorption is common with hydrophilic agents, whereas extra care is needed in patients with renal impairment. For most patients, especially those with asymptomatic conditions, once-daily dosing is preferred. For many, the quality of life is of overriding clinical importance. Despite significant pharmacokinetic and pharmacodynamic advances, the final criteria depend largely on a clinical assessment, improvement in the quality of life, and patient preference. We still await the discovery of an ideal beta-adrenoceptor blocking agent; some of the newer beta-blockers, however have many of the properties that clinicians value.

journal_name

Am Heart J

journal_title

American heart journal

authors

Reid JL

doi

10.1016/0002-8703(88)90130-5

subject

Has Abstract

pub_date

1988-11-01 00:00:00

pages

1400-4

issue

5 Pt 2

eissn

0002-8703

issn

1097-6744

pii

0002-8703(88)90130-5

journal_volume

116

pub_type

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