Document Detail

Beta1- or beta2-blockers to improve hemodynamics following endotracheal adrenaline administration.
MedLine Citation:
PMID:  16086554     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The recommended dose for endotracheal adrenaline (0.02 mg/kg) causes a pronounced initial decrease in diastolic blood pressure which is detrimental at the initial phase of cardiopulmonary resuscitation. This effect was previously attributed to an early and preferential stimulation of the beta-adrenergic receptors causing vasodilatation unopposed by an alpha-adrenergic vasoconstriction. We hypothesized that inhibition of the beta2-adrenoreceptors is responsible for prevention of the deleterious initial decrease in blood pressure that takes place following endotracheal administration of adrenaline. METHODS: Adrenaline (0.02 mg/kg) diluted with normal saline (5 ml) was injected into the endobronchial tree of anesthetized dogs 3 min following pretreatment with the non-selective beta-blocker propranolol, selective beta1-blocker metoprolol (0.1 mg/kg, i.v.), or without pre-treatment. Heart rate, blood pressure and arterial blood gases were monitored. RESULTS: The selective beta-blocker metoprolol was almost as effective as the non-selective beta-blocker propranolol in attenuating the initial decrease in blood pressure following endotracheally administered adrenaline, a phenomenon that was previously attributed to inhibition of beta-adrenoreceptors. CONCLUSIONS: The outcome of this study might be explained by a dose-related loss of cardioselectivity of metoprolol. Further studies are warranted to refine the pharmacological means to abort the initial blood pressure-lowering effect of endotracheally administered adrenaline.
Ron Ben-Abraham; David Stepensky; Yudith Assoulin-Dayan; Ori Efrati; Danny Lotan; Yossi Manisterski; Mati Berkovitch; Zohar Barzilay; Gideon Paret
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Drug metabolism and drug interactions     Volume:  21     ISSN:  0792-5077     ISO Abbreviation:  Drug Metabol Drug Interact     Publication Date:  2005  
Date Detail:
Created Date:  2005-08-09     Completed Date:  2005-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8904736     Medline TA:  Drug Metabol Drug Interact     Country:  England    
Other Details:
Languages:  eng     Pagination:  31-9     Citation Subset:  IM    
Department of Anesthesiology and Critical Care, Tel Aviv Sourasky Medical Center, Tel Hashomer, Israel.
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MeSH Terms
Adrenergic beta-Antagonists / pharmacology*
Blood Pressure / drug effects*
Epinephrine / administration & dosage*
Heart Rate / drug effects
Metoprolol / pharmacology*
Propranolol / pharmacology*
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 37350-58-6/Metoprolol; 51-43-4/Epinephrine; 525-66-6/Propranolol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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