Beta Blockers for Migraine
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Still an Important Cause of Heart Failure?
Journal of Human Hypertension (2005) 19, 267–275 & 2005 Nature Publishing Group All rights reserved 0950-9240/05 $30.00 www.nature.com/jhh REVIEW ARTICLE Hypertension — still an important cause of heart failure? E Kazzam1, BA Ghurbana2, EN Obineche1 and MG Nicholls1 1Department of Internal Medicine, Faculty of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates; 2Department of Medicine, Al Ain Hospital, Al Ain, United Arab Emirates Hypertension has been the single most important risk from highly selected study groups in tertiary referral factor for heart failure until the last few decades. Now, it centres to patients with heart failure in primary and is frequently claimed that atherosclerotic coronary secondary care, may not be justified. Finally, the artery disease dominates as the major underlying cause, situation of heart failure primarily due to impaired left and hypertension is of lesser importance. We here ventricular diastolic function, where hypertension is a review evidence regarding the contribution of hyperten- frequent precursor, is often ignored in discussions of sion to heart failure in the recent decades. It is not aetiology. Our view is that hypertension remains and possible, in our view, to be confident of the relative probably is the single most, important modifiable risk importance of hypertension and coronary artery disease factor for cardiac failure in some races and countries, since there are significant limitations in the available where the dominant cardiac abnormality is left ventri- data. The often-questionable diagnostic criteria used in cular diastolic dysfunction. The situation is less clear for defining heart failure is one such limitation. -
Association of Hypertensive Status and Its Drug Treatment with Lipid and Haemostatic Factors in Middle-Aged Men: the PRIME Study
Journal of Human Hypertension (2000) 14, 511–518 2000 Macmillan Publishers Ltd All rights reserved 0950-9240/00 $15.00 www.nature.com/jhh ORIGINAL ARTICLE Association of hypertensive status and its drug treatment with lipid and haemostatic factors in middle-aged men: the PRIME Study P Marques-Vidal1, M Montaye2, B Haas3, A Bingham4, A Evans5, I Juhan-Vague6, J Ferrie`res1, G Luc2, P Amouyel2, D Arveiler3, D McMaster5, JB Ruidavets1, J-M Bard2, PY Scarabin4 and P Ducimetie`re4 1INSERM U518, Faculte´ de Me´decine Purpan, Toulouse, France; 2MONICA-Lille, Institut Pasteur de Lille, Lille, France; 3MONICA-Strasbourg, Laboratoire d’Epide´miologie et de Sante´ Publique, Strasbourg, France; 4INSERM U258, Hoˆ pital Broussais, Paris, France; 5Belfast-MONICA, Department of Epidemiology, The Queen’s University of Belfast, UK; 6Laboratory of Haematology, La Timone Hospital, Marseille, France Aims: To assess the association of hypertensive status this effect remained after multivariate adjustment. Cal- and antihypertensive drug treatment with lipid and hae- cium channel blockers decreased total cholesterol and mostatic levels in middle-aged men. apoproteins A-I and B; those differences remained sig- Methods and results: Hypertensive status, antihyperten- nificant after multivariate adjustment. ACE inhibitors sive drug treatment, total and high-density lipoprotein decreased total cholesterol, triglycerides, apoprotein B (HDL) cholesterol, triglyceride, apoproteins A-I and B, and LpE:B; and this effect remained after multivariate lipoparticles LpA-I, -
Advantages and Disadvantages of Beta- Adrenergic Blocking Drugs in Hypertension
Reprinted from ANCIOLOCY Vol. 29, No. -I April 1978 Copyright 0 1978 Prinred in U.S.A. All Rights Rewrced Advantages and Disadvantages of Beta- Adrenergic Blocking Drugs in Hypertension Eoin T. O'Brien DUBLIN, IRELAND General Measures Elevation of blood pressure should be regarded as one of a number of potential risk factors for cardiovascular disease-albeit a major risk factor- rather than a disease per se.' It is important to identify additional risk factors in the hypertensive patient, not only because collectively these factors may greatly magnify the cardiovascular risk, but also because modification of them may, of itself, lower the blood pressure and thus alleviate the risk and save the patient the inconvenience, expense, and potential harm that may result from even the simplest of drug regimes. Careful consideration should be given to the patient's diet (particularly in relation to the calorie intake in the case of obesity, the cholesterol and saturated fat content in the case of hyperlipidemia and patients at high risk, and the salt content) and to smoking habits, physical activity. stress. personality, and drug therapy, especially anovulant preparations. Other diseases, such as diabetes mellitus, which are associated with a high incidence of hypertension and pri- mary causes of hypertension must be excluded. Although there is still no statistical evidence to show that modification of these risk factors-with the exception of tobacco and anovulant preparations-will actually reduce mortal- ity, it does seem prudent on the basis of the evidence available to encourage the hypertensive patient to adjust his or her life-style not only to reduce the cardiovascular risk,2 but also because in many instances the mildly hypertensive patient will respond to this approach alone. -
Drug Class Review Antianginal Agents
Drug Class Review Antianginal Agents 24:12.08 Nitrates and Nitrites 24:04.92 Cardiac Drugs, Miscellaneous Amyl Nitrite Isosorbide Dinitrate (IsoDitrate ER®, others) Isosorbide Mononitrate (Imdur®) Nitroglycerin (Minitran®, Nitrostat®, others) Ranolazine (Ranexa®) Final Report May 2015 Review prepared by: Melissa Archer, PharmD, Clinical Pharmacist Carin Steinvoort, PharmD, Clinical Pharmacist Gary Oderda, PharmD, MPH, Professor University of Utah College of Pharmacy Copyright © 2015 by University of Utah College of Pharmacy Salt Lake City, Utah. All rights reserved. Table of Contents Executive Summary ......................................................................................................................... 3 Introduction .................................................................................................................................... 4 Table 1. Antianginal Therapies .............................................................................................. 4 Table 2. Summary of Agents .................................................................................................. 5 Disease Overview ........................................................................................................................ 8 Table 3. Summary of Current Clinical Practice Guidelines .................................................... 9 Pharmacology ............................................................................................................................... 10 Table 4. Pharmacokinetic Properties -
COPD Agents Review – October 2020 Page 2 | Proprietary Information
COPD Agents Therapeutic Class Review (TCR) October 1, 2020 No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, digital scanning, or via any information storage or retrieval system without the express written consent of Magellan Rx Management. All requests for permission should be mailed to: Magellan Rx Management Attention: Legal Department 6950 Columbia Gateway Drive Columbia, Maryland 21046 The materials contained herein represent the opinions of the collective authors and editors and should not be construed to be the official representation of any professional organization or group, any state Pharmacy and Therapeutics committee, any state Medicaid Agency, or any other clinical committee. This material is not intended to be relied upon as medical advice for specific medical cases and nothing contained herein should be relied upon by any patient, medical professional or layperson seeking information about a specific course of treatment for a specific medical condition. All readers of this material are responsible for independently obtaining medical advice and guidance from their own physician and/or other medical professional in regard to the best course of treatment for their specific medical condition. This publication, inclusive of all forms contained herein, is intended to be educational in nature and is intended to be used for informational purposes only. Send comments and suggestions to [email protected]. October 2020 -
CORGARD® TABLETS Nadolol Tablets USP
CORGARD® TABLETS Nadolol Tablets USP Rx Only DESCRIPTION CORGARD (nadolol) is a synthetic nonselective beta-adrenergic receptor blocking agent designated chemically as 1-(tert-butylamino)-3-[(5,6,7,8-tetrahydro-cis-6,7-dihydroxy-1- naphthyl)oxy]-2-propanol. Structural formula: C17H27NO4 MW 309.40 Nadolol is a white crystalline powder. It is freely soluble in ethanol, soluble in hydrochloric acid, slightly soluble in water and in chloroform, and very slightly soluble in sodium hydroxide. CORGARD (nadolol) is available for oral administration as 20 mg, 40 mg, and 80 mg tablets. Inactive ingredients: microcrystalline cellulose, colorant (FD&C Blue No. 2), corn starch, magnesium stearate, povidone (except 20 mg and 40 mg), and other ingredients. CLINICAL PHARMACOLOGY CORGARD (nadolol) is a nonselective beta-adrenergic receptor blocking agent. Clinical pharmacology studies have demonstrated beta-blocking activity by showing (1) reduction in heart rate and cardiac output at rest and on exercise, (2) reduction of systolic and diastolic blood pressure at rest and on exercise, (3) inhibition of isoproterenol-induced tachycardia, and (4) reduction of reflex orthostatic tachycardia. CORGARD (nadolol) specifically competes with beta-adrenergic receptor agonists for available beta receptor sites; it inhibits both the beta1 receptors located chiefly in cardiac muscle and the beta2 receptors located chiefly in the bronchial and vascular musculature, inhibiting the chronotropic, inotropic, and vasodilator responses to beta-adrenergic stimulation proportionately. CORGARD has no intrinsic sympathomimetic activity and, unlike some other beta-adrenergic blocking agents, nadolol has little direct myocardial depressant activity and does not have an anesthetic-like membrane- stabilizing action. Animal and human studies show that CORGARD slows the sinus rate and depresses AV conduction. -
Psychedelics in Psychiatry: Neuroplastic, Immunomodulatory, and Neurotransmitter Mechanismss
Supplemental Material can be found at: /content/suppl/2020/12/18/73.1.202.DC1.html 1521-0081/73/1/202–277$35.00 https://doi.org/10.1124/pharmrev.120.000056 PHARMACOLOGICAL REVIEWS Pharmacol Rev 73:202–277, January 2021 Copyright © 2020 by The Author(s) This is an open access article distributed under the CC BY-NC Attribution 4.0 International license. ASSOCIATE EDITOR: MICHAEL NADER Psychedelics in Psychiatry: Neuroplastic, Immunomodulatory, and Neurotransmitter Mechanismss Antonio Inserra, Danilo De Gregorio, and Gabriella Gobbi Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, Quebec, Canada Abstract ...................................................................................205 Significance Statement. ..................................................................205 I. Introduction . ..............................................................................205 A. Review Outline ........................................................................205 B. Psychiatric Disorders and the Need for Novel Pharmacotherapies .......................206 C. Psychedelic Compounds as Novel Therapeutics in Psychiatry: Overview and Comparison with Current Available Treatments . .....................................206 D. Classical or Serotonergic Psychedelics versus Nonclassical Psychedelics: Definition ......208 Downloaded from E. Dissociative Anesthetics................................................................209 F. Empathogens-Entactogens . ............................................................209 -
0Bcore Safety Profile
Core Safety Profile Active substance: Levobunolol Pharmaceutical form(s)/strength: Eye drops solution/ 0,1%; 0,25%; 0,5%; 0,5% UD P-RMS: CZ/H/PSUR/0006/001 Date of FAR: 26.05.2009 4.2 Posology and method of administration Adults (including the elderly) Country specific posology and method of administration to be included. Children /.../ is not recommended for use in children due to lack of safety and efficacy data. If required, /.../ may be used with other agents to lower intra-ocular pressure. The use of two topical beta-adrenergic blocking agents is not recommended (see section 4.4). Intraocular pressure should be measured approximately four weeks after starting treatment with /.../ as a return to normal ocular pressure can take a few weeks. As with any eye drops, to reduce possible systemic absorption, it is recommended that the lachrymal sac is compressed at the medial canthus (punctual occlusion) for one minute. This should be performed immediately following the instillation of each drop. Transfer from other beta-blocking treatment When another beta blocking agent is being used treatment must be discontinued after a full day of therapy. Start treatment with /.../ the next day with X drop of /.../ topically applied into the conjunctival sac in the affected eye(s). If /.../ is to replace a combination of anti-glaucoma products, only a single product should be removed at a time. Use in renal and hepatic impairment Levobunolol hydrochloride has not been studied in patients with hepatic or renal impairment. Therefore, caution should be used in treating such patients (see section 4.4). -
Metered-Dose Inhalers (Mdis): Anti-Cholinergic Drugs
Texas Vendor Drug Program Drug Use Criteria: Aerosolized Agents - Metered-Dose Inhalers (MDIs): Anti-Cholinergic Drugs Publication History 1. Developed January 1995. 2. Revised April 2021; March 2019; March 2017; November 2015; March 2014; August 2012; June 2012; October 2010; January 2008; January 2003; January 2002; January 2001; March 2000; January 2000; February 1999; February 1998; February 1997; August 1995. Notes: All criteria may be applied retrospectively. The information contained is for the convenience of the public. The Texas Health and Human Services Commission is not responsible for any errors in transmission or any errors or omissions in the document. Medications listed in the tables and non-FDA approved indications included in these retrospective criteria are not indicative of Vendor Drug Program formulary coverage. Prepared by: • Drug Information Service, UT Health San Antonio. • The College of Pharmacy, The University of Texas at Austin 1 1 Dosage 1.1 Adults Ipratropium (Atrovent®), a short-acting, inhalational anticholinergic agent, is FDA- approved to manage bronchospasm associated with chronic bronchitis and emphysema, collectively known as chronic obstructive pulmonary disease (COPD). Ipratropium is considered a second-line agent in the treatment of asthma as the bronchodilatory effects seen with ipratropium are less than those seen with beta- adrenergic drugs. While not FDA approved, the Expert Panel 3 guidelines from the National Heart Lung and Blood Institute document benefit when multiple ipratropium doses are administered adjunctively with beta2-agonists in the emergency department to manage more severe acute asthma exacerbations, and the Global Initiative for Asthma (GINA) guidelines state that ipratropium may be considered an alternative bronchodilator in patients who experience adverse effects to short-acting beta2-agonists (e.g., tachycardia, arrhythmia, tremor). -
BETA RECEPTOR BLOCKERS MC Objective
Jack DeRuiter, Principles of Drug Action 2, Fall 2000 ADRENERGIC RECEPTOR ANTAGONISTS: BETA RECEPTOR BLOCKERS MC Objective: Describe the development of beta antagonists ("beta blockers") from the agonist norepinephrine (NE): HO H NH2 NE Alpha- and Beta-receptor agonist HO OH H H HO CH N 3 H Isoproterenol CH3 Selective beta-receptor agonist HO OH H H HO CH N 3 H Dichloroisoproterenol CH3 Partial beta-receptor agonist/antagonist Cl Cl H H HO CH N 3 Pronethalol H Beta-receptor antagonist, CH 3 low activity and toxic CH3 O N H Propranolol CH3 OH H Potent beta-antagonist No beta-receptor subtype selectivity CH3 CH3 O N H O N H CH CH OH H 3 OH H 3 Metoprolol N Beta-1-receptor H Pindolol O subtype selectivity Partial beta-agonist CH3 No beta-receptor subtype selectivity HO H H N H CH3 HO Labetolol O NH2 Dual alpha- and beta-antagonst 1 Jack DeRuiter, Principles of Drug Action 2, Fall 2000 MC Objective: Based on their structures, would the beta-blockers be expected to be relatively receptor selective? YES. They do not produce significant blockade of alpha- adrenergic receptors (alpha-1 or alpha-2), histamine receptors, muscarinic receptors or dopamine receptors. MC/PC Objective: Identify which beta blockers are classified as "non-selective": · The “non-selective" classification refers to those beta-blockers capable of blocking BOTH beta-1 and beta-2 receptors with equivalent efficacy. These drugs DO NOT have clinically significant affinity for other neurotransmitter receptors (alpha, dopamine, histamine, acetylcholine, etc.). · ALL of these beta-blockers (except satolol) consist of an aryloxypropanolamine side chain linked to an aromatic or “heteroaromatic” ring which is “ortho” substituted. -
Rational Use of Beta Blockers in Management of Hypertension Khawaja Tahir Mehmood, Fatima Amin, Hafiza Kiran Ismail, Ayesha Irfan
Khawaja Tahir Mahmood et al /J. Pharm. Sci. & Res. Vol.3(1), 2011,1029-1034 Rational Use of Beta Blockers in Management of Hypertension Khawaja Tahir Mehmood, Fatima Amin, Hafiza Kiran Ismail, Ayesha Irfan. Lahore College for women university Lahore, Pakistan Abstract: Hypertension is an extremely common disorder. It is major risk factor for cardiovascular morbidity and mortality through its effects on target organs like brain heart kidney eyes. In Pakistan magnitude of problem of uncontrolled hypertension is greater. .Treatment of hypertension decreases morbidity and increases life expectancy. Beta blockers are widely used in the treatment of hypertension. Beta blockers are effective only when they are rationally prescribed and used. It is retrospective type of study during which data of 50 hypertensive patients with primary hypertension using beta blockers were collected to analyze whether beta blockers are rationally prescribed and used. After therapy with beta blockers Blood pressure is effectively controlled. After the therapy 20 % patient have B.P in range of 110-130, 56% patients have B.P in range of 120- 130 and 24% have B.P in range of 130-140.It is concluded that blood pressure is effectively controlled when beta blockers rationally used. It should be given with caution in older and diabetic patients because it increases the risk of stroke in older patients. It is most effective when given in combination. Key words; Beta blockers, Hypertension, rational use, INTRODUCTION: systolic hypertension, white coat hypertension Hypertension is defined as either a sustained and resistant hypertension. (5, 6) systolic blood pressure of greater than 140 Although exact causes of primary hypertension mmHg or sustained diastolic blood pressure of is not fully understood it is known that some greater than 90mmHg. -
Comparison of Effectiveness and Safety of Labetalol and Hydralazine on Blood Pressure During Cataract Surgery in Patients with Hypertensio
Revista Latinoamericana de Hipertensión ISSN: 1856-4550 [email protected] Sociedad Latinoamericana de Hipertensión Venezuela Comparison of effectiveness and safety of labetalol and hydralazine on blood pressure during cataract surgery in patients with hypertensio Espahbodi, Ebrahim; Takzare, Alireza; Sanatkar, Mehdi; Goudarzi, Mehrdad Comparison of effectiveness and safety of labetalol and hydralazine on blood pressure during cataract surgery in patients with hypertensio Revista Latinoamericana de Hipertensión, vol. 14, no. 4, 2019 Sociedad Latinoamericana de Hipertensión, Venezuela Available in: https://www.redalyc.org/articulo.oa?id=170263002018 Derechos reservados. Queda prohibida la reproducción total o parcial de todo el material contenido en la revista sin el consentimiento por escrito del editor en jefe. Copias de los artículos: Todo pedido de separatas deberá ser gestionado directamente con el editor en jefe, quien gestionará dicha solicitud ante la editorial encargada de la publicación. This work is licensed under Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International. PDF generated from XML JATS4R by Redalyc Project academic non-profit, developed under the open access initiative Revista Latinoamericana de Hipertensión, 2019, vol. 14, no. 4, ISSN: 1856-4550 Artículos Comparison of effectiveness and safety of labetalol and hydralazine on blood pressure during cataract surgery in patients with hypertensio Comparación de la efectividad y la seguridad de labetalol e hidralazina en la presión arterial