Beta blockers are widely used in the management of cardiac conditions and thyrotoxicosis, and to reduce perioperative complications. Asthma and chronic obstructive pulmonary disease (COPD) have been classic contraindications to the use of beta blockers because of their potential for causing bronchospasm. The identification of cardioselective beta blockers that have significantly greater affinity for beta receptors offers a sub- group of beta blockers that are less likely to cause bronchospasm. Salpeter and associates analyzed data from randomized, blinded, placebo-controlled trials to evaluate the effect of cardioselective beta blockers on patients with reactive airway disease, including asthma or COPD with a reversible component. Eligible studies could use oral or intravenous dosing given as a single dose or as continuous treatment. Of the 29 studies included in this meta-analysis, 19 studied single-dose treatment in a total of 240 patients. The cardioselective beta blockers without intrinsic sympathomimetic activity that were used in the study included atenolol, metoprolol, bisoprolol, and practolol. Elsy Viviana Navas, MDDepartment of Cardiovascular Medicine, Cleveland Clinic David O. Taylor, MDDepartment of Cardiovascular Medicine, Critical Care Center, and Transplantation Center, Cleveland Clinic Address: David O. Taylor, MD, Department of Cardiovascular Medicine, J3, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195; e-mail [email protected] Treatment with beta-adrenergic receptor blockers decreases the mortality rate in patients with coronary artery disease or heart failure, as well as during the perioperative period in selected patients (eg, those with a history of myocardial infarction, a positive stress test, or current chest pain due to myocardial ischemia). The current evidence supports giving beta-blockers to patients with coronary artery disease and chronic obstructive pulmonary disease (COPD) or asthma, which lowers the 1-year mortality rate to a degree similar to that in patients without COPD or asthma, and without worsening respiratory function. However, these data are from small trials in the 1970s and 1980s. On the other hand, not giving beta-blockers can pose a risk of death.
It has long been suggested that beta-blockers—drugs commonly used to treat hypertension and other cardiovascular conditions—may be problematic in people with severe asthma or chronic obstructive pulmonary disease (COPD). This was due in large part to studies from the 1970s and 1980s, which suggested that the drugs amplify the sensitivity of lung tissues and, by doing so, increased the risk of bronchial spasms. But many of those assertions have since been challenged, with most experts today agreeing that the benefits of beta-blockers far outweigh the potential consequences. With the development of newer cardioselective beta-blockers, the risks are even less. Even so, care needs to be taken when beta-blockers are used in people with severe asthma or COPD to avoid potentially serious exacerbations. They were once considered off-limits for people with reactive lung disease (RAD) due to their generalized mechanism of action. The drugs block the effects of epinephrine, the hormone responsible for increases in heart rate. The three groups of medication most likely to cause a reaction are aspirin/NSAIDs, beta-blockers, and ACE inhibitors. However, reactions can occur with other drugs as well. Pay attention to any symptoms that start when you take a new medication. Report any medication-related asthma attacks to your health care provider. Aspirin is also called acetylsalicylic acid or ASA. It belongs to a group of medications called NSAIDs, which stands for non-steroidal anti-inflammatory drugs. Other common NSAIDs are naproxen (ex: Aleve) and ibuprofen (ex: Advil, Motrin).
Guideline Recommended Practice Prescribing Beta Blocker therapy to patients with LV Systolic Dysfunction Use of 1 of the 3 beta blockers proven to reduce mortality is recommended for all stable patients with current or prior symptoms of heart failure and reduced LVEF. Unless contraindicated, patients with LV systolic dysfunction should be treated with one of the three following beta-blockers: *Prescribe may include prescription given to the patient for beta-blocker therapy at one or more visits in the measurement period OR patient already taking betablocker therapy as documented in current medication list SPECIAL NOTE: This measure is paired with performance measure "Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction". It comes as immediate-release and extended-release oral tablets, and extended-release oral capsules. It also comes in an injectable form that’s only given by a healthcare provider. Metoprolol oral tablets are available as the brand-name drugs Lopressor and Toprol XL. Generic drugs usually cost less than the brand-name versions. In some cases, they may not be available in all strengths or forms as the brand-name drugs. The two brand-name forms of metoprolol (as well as the different generic forms) are different versions of the medication. They’re both metoprolol, but they contain different salt forms. The different salt forms enable the drugs to be used to treat different conditions. Metoprolol succinate is an extended-release version of metoprolol, so it remains in your bloodstream for a longer time.
Yes. Treatment with beta-adrenergic receptor blockers decreases the mortality rate in patients with coronary artery disease or heart failure, as well as during the. Sep 1, 2003. This group of drugs includes propranolol, atenolol and metoprolol. If you have started taking a beta-blocker and your asthma gets worse, tell.