Journal of Clinical & Experimental Pharmacology

Pharmacology of ischemic heart disease: Concomitant diseases and choice of beta blocker

17^th International Conference on PHARMACOLOGY AND DRUG DISCOVERY

June 15-16, 2023 | Rome, Italy

Mohy Eldeen Mohammed

Hurghada General Hospital, Egypt

Scientific Tracks Abstracts: J Clin Exp Pharmacol

Abstract:

Concomitant Diseases and Choice of β-Blocker: Respiratory disease. Cardioselective β1-blockers in low doses are best for patients with reversible bronchospasm. In patients with a history of asthma, no β-blocker can be considered safe. Associated cardiovascular disease. For hypertension plus effort angina, see “β-blockers for hypertension” earlier in this chapter. In patients with sick sinus syndrome, pure β-blockade can be dangerous. β-blockers with ISA may be best. In patients with Raynaud phenomenon, propranolol with its peripheral vasoconstrictive effects is best avoided. In active peripheral vascular disease, β-blockers are generally contraindicated, although the evidence is not firm. Renal disease. The logical choice should be a β-blocker eliminated by the liver rather than the kidney. Of those, the vasodilating β-blocker nebivolol conserved the estimated glomerular filtration rate in patients with heart failure better than did metoprolol. Diabetes mellitus. In diabetes mellitus, the risk of β-blockade in insulin-requiring diabetics is that the premonitory symptoms of hypoglycemia might be masked. There is a lesser risk with the cardioselective agents. In type 2 diabetics with hypertension, initial β-blocker therapy by atenolol was as effective as the ACE inhibitor, captopril, in reducing macrovascular endpoints at the cost of weight gain and more antidiabetic medication. Whether diabetic nephropathy benefits as much from treatment with β-blockade is not clear. ARBs and ACE inhibitors have now established themselves as agents of first choice in diabetic nephropathy. Carvedilol combined with renin angiotensin system (RAS) blocker therapy in diabetic patients with hypertension results in better glycemic control and less insulin resistance than combination therapy that includes metoprolol. Although better glycemic control should theoretically translate into fewer cardiovascular events and other adverse outcomes, the short-term nature of this study does not allow conclusions on outcomes. Those at risk of new diabetes. The use of β-blockers and diuretics poses a risk of new diabetes which should be lessened by a truly low dose of the diuretic or by using another combination. Regular blood glucose checks are desirable.

Biography :

Mohy Eldeen Mohammed, resident of cardiovascular disease, Hurghada General Hospital, Red Sea, Egypt.