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Author: Admin | 2025-04-28
Non-cardioselective beta-blockers appear to pose the greatest risk to patients with asthma or COPD.Non-cardioselective beta-blockers appear to pose the greatest risk to patients with asthma or COPDThe potential interaction between beta-blockers and beta-agonists is a classic example of a pharmacodynamic drug interaction. It would appear that the administration of beta-blockers to patients taking beta-agonists should be avoided in all cases and some have recommended this action. However, differences in the activity of beta receptors and receptor selectivity of drugs binding to beta receptors add a level of complexity that precludes broad drug class—based interaction recommendations.Beta-blockers and Beta-agonists in AsthmaBeta-agonists are commonly used in the treatment of asthma and chronic obstructive pulmonary disease (COPD). Beta-blocker use in asthma has been widely studied. In general, cardioselective beta-blockers (eg, acebutolol, atenolol, bisoprolol, celiprolol, metoprolol) appear to be effective for the treatment of thyrotoxicosis, tachyarrhythmias, hypertension, heart failure, and acute coronary syndrome without increased risk of asthma exacerbation.1,2In an analysis of 10 studies on the effect of beta-blockers in patients with asthma where selective beta-blockers were administered for up to 14 weeks, there was no change compared with placebo in FEV1, symptoms, or inhaler use.1 Further, the use of selective beta-blockers following the administration of a beta-agonist produced a greater increase in FEV1 than placebo. While there are few data on the use of non-cardioselective beta-blockers (eg, carvedilol, nadolol, pindolol, propranolol, timolol) in patients with asthma, it would seem prudent to avoid beta-blockers that inhibit the beta-2 receptor in patients using beta-2 agonists.Beta-blockers and Beta-agonists in COPDA number of studies have evaluated the use of beta-blockers in patients with COPD.1,3-7 As was observed in studies in patients with asthma, COPD patients being treated with beta-agonists showed no detrimental effects (reduced airway function or disease exacerbations) of cardioselective beta-blockers.1,4 A retrospective study of COPD patients reported that those taking beta-blockers were less likely to have an exacerbation of their disease and this result was independent of the cardioselectivity of the beta-blocker.5 However, more than 75% of the patients were receiving a cardioselective beta-locker, limiting the ability of this study to assess the relative risk of
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