Neither atenolol nor celiprolol affected daily asthma control and inhaler use in our study. Four conditions of the study need to be borne in mind: (1) the dose and duration of beta-blockers used; (2) the small number of subjects studied; (3) the mild nature of their asthma; and (4) the absence of events such as chest infections which might have had more severe consequences in those on beta-blockers. In a previous study of subjects with mild asthma treated with 100 mg atenolol, only small clinically insignificant bron-choconstrictive changes were found. Judging by their low medication requirements (five required only intermittent treatment and three required a beta-2 agonist inhaler alone), as well as symptom scores and spirometry, most subjects in our study had only mild asthma. However, it is not known what would have happened to respiratory function if these subjects with asthma had been exposed to some asthma trigger factors other than withdrawal of beta-2 stimulation, for example, upper respiratory tract infection. more
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In this study on a small group of selected patients Adth coexisting hypertension and asthma, a singledose challenge with atenolol, 100 mg, caused bron-choconstriction in most subjects, while the response to single-dose challenge with celiprolol, 400 mg, closely resembled that with placebo. Without the sustained bronchodilator benefit of beta-2 agonists during the preceding 10-h period, the adverse effect of atenolol on FEVi, FVC and PEF was obvious. canadian health&care mall
Following salbutamol inhalation, respiratory parameters improved to prechallenge levels (p<0.05), suggesting that atenolol, 100 mg, is sufficiently cardio-selective to preserve a clinical bronchial responsiveness to beta-2 agonists. Read the rest of this entry »
Adverse effects were mild and most occurred during the placebo phase. Two patients complained of tiredness and mild ankle swelling, and another had headaches while taking atenolol.
Blood Pressure and Pulse Rates
All diastolic blood pressures fell significantly during both celiprolol and atenolol treatment, but systolic blood pressure taken with the patient in a supine position was reduced only by atenolol therapy (Table 2). Mean diastolic blood pressure values during the two treatment periods were similar. Five patients who were taking celiprolol and four who were taking atenolol achieved ideal diastolic blood pressure values (below 90 mm Hg or a reduction of more than 10 mm Hg). Read the rest of this entry »
During each phase of the study, including the run-in period, patients recorded the following on diary cards:
1. Symptom scores of cough and dyspnea during the preceding 12 h (twice daily recordings). Cough was scored as follows: (a) no cough, (b) occasional cough, (c) bad cough— intermittently, (d) bad cough most of the time. Dyspnea was scored as follows: (a) did not wake up at night, (b) awoke one to three times but slept between, (c) awoke four to six times but slept between, (d) awoke more than six times. Read the rest of this entry »
Patients were permitted to use their usual bronchodilator therapy throughout the study (Table 1) except during the 10-h period before a clinic visit. No antihypertensive agents other than the trial medications were allowed. Throughout the 12-week study, patients had 24-h telephone access to a doctor, and were encouraged to report even minor changes in respiratory and other symptoms.
After a single-blind two-week placebo run-in period, the patients were randomly given in a double-blind manner either 100 mg atenolol or 400 mg celiprolol daily for four weeks. Thereafter, all patients completed a two-week placebo crossover period and then received the alternative beta-blocker daily for a further four-week period (Fig 1). Read the rest of this entry »
The danger of using beta-adrenergic blockers and particularly those without cardiac selectivity in asthmatic patients has been known for more than 20 years. Even relatively cardioselective agents (including atenolol) have been shown to produce significant bronchoconstriction, and for this reason are strictly contraindicated in asthma. One possible way of overcoming the adverse effects of beta-blockade is to use an agent which has additional beta-2 stimulating qualities (beta-2 intrinsic sympathomimetic activity or beta-2 ISA). The latter could provide a degree of bronchodilation despite existing beta 1 blockade. Celiprolol has been reported to possess such bronchosparing qualities and even to dilate the bronchi in animals and in single-dose human studies. These reports prompted us to evaluate the respiratory effects of this drug in hypertensive asthmatics in a doubleblind crossover comparison with a better-known cardioselective beta-blocker, atenolol. Read the rest of this entry »
The failure to observe a fall in ventilation after methacholine challenge is not likely to result from our use of the Respitrace, since this device tended to underestimate the tidal volume changes following induced bronchoconstriction. It thus seems likely that much of the hypoxemia resulted from changes in the distribution of alveolar ventilation to perfusion ratios within lung alveoli following bronchoconstriction. Read the rest of this entry »