Summary
D-alprenolol, in doses of 50–170 mg, was given intravenously to 23 patients with various cardiac arrhythmias. Seven patients had acute myocardial infarction, ten patients had chronic ischemic heart disease with rhythm disturbances, three were in congestive failure and one had myocarditis. The ventricular arrhythmias were abolished in several patients. In some of the patients with compromised myocardial function, the blood pressure dropped markedly and heart rate slowed to a degree requiring treatment. These effects have been seen after other β-adrenergic blocking agents, and were considered to be due mainly to the cardiodepressive action of D-alprenolol in the doses used. Because of these potentially dangerous side effects, and because little benefit was apparent over other drugs, it was concluded that D-alprenolol should not be used for the treatment of arrhythmias in patients who have myocardial damage.
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References
Åblad, B.: Personal communication.
Belliveau, R.E., Covino, B.G.: Effects of a new β-adrenergic receptor blocking agent, alprenolol, and its optical isomers. Arch. int. Pharmacodyn.180, 341–349 (1969).
Brändström, A.: Personal communication.
Duce, B.R., Garberg, L.: Effect of alprenolol — a new beta-adrenergic receptor blocking agent and its optical isomers on arrhythmias following coronary artery occlusion in dogs. Fed. Proc.28, 477 (1969).
—— —— Johansson, B.: The effect of prepranolol and the dextro and laevo isomers of H 56/28 upon ouabain-induced ventricular tachycardia in unanaesthetized dogs. Acta Pharmacol.25, suppl. 2, 41–49 (1967).
Ekelund, I.-G., Melcher, A., Orö, L.: Central haemodynamic effects of the dextro-isomer of alprenolol infused into man at rest and during exercise. In preparation.
Gibson, D., Sowton, E.: The use of beta-adrenergic receptor blocking drugs in dysrhythmias. Progress in Cardiovasc. Dis.12, 16–39 (1969).
Howe, R., Shanks, R. G.: Optical isomers of propranolol. Nature210, 1336–1338 (1966).
Katz, R.L., Lord, C.O., Eakins, K.E.: Anesthetic-dopamine cardiac arrhythmias and their prevention by betaadrenergic blockade. J. Pharmacol. exp. Ther.158, 40–45 (1967).
Kreus, K.-E., Salokannel, S.J., Isomäki, H., Waris, E.K.: Alprenolol in the treatment of arrhythmias in acute coronary patients. Acta med. scand.188, 375–378 (1970).
Linko, E., Ruosteenoja, R., Siitonen, L.: A clinical study on the mechanism of the antiarrhythmic action of a new antagonist to beta-adrenergic receptors. Amer. Heart J.75, 139–140 (1968).
Lord, C.O., Katz, R.L., Eakins, E.K.: Anti-arrhythmic properties of stereoisomers of a beta-adrenergic blocking agent (H 56/28). Anesthesiology29, 288–294 (1968).
Lucchesi, B.R.: The effects of prenethalol and its dextro isomer upon experimental cardiac arrhythmias. J. Pharmacol. exp. Ther.148, 94–99 (1965).
—— Whitsite, L.S., Iwami, T.: Effect of propranolol and its dextro-isomer on experimentally induced arrhythmias. In: Kattus, Ross, Hall (Ed.): Beta adrenergic responses. P. 21. Univ. of Cal. Press, Berkeley, 1970.
Madan, B.R., Mischra, S.N., Khanna, V.K.: Effect of dextro-and laevo rotary isomers of H56/28 on experimental ventricular arrhythmias. Arch. int. Pharmacodyn.182, 121–129 (1969).
Saunamäki, K.: Studies on the anti-arrhythmic effect of dextro-alprenolol. Investigation of the anti-arrhythmic affect of dextro-alprenolol. Europ. J. Clin. Pharmacol.3, 23–31 (1970).
Sowton, E., Bennett, D., Smith, E., Balcon, R., Gibson, D.: Antidysrythmic effects of beta-blocking drugs. in: Symposium on Cardiac Arrhythmias, Elsinore, Denmark, 1970 p. 479–493.
Vohra, J.K., Thompson, P.L., Sloman, J.G.: Clinical experience with dextro-alprenolol. Brit. med. J.1970 I, 791–792.
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Gatzinska, R., Henning, R., Nyberg, G. et al. Clinical trial of intravenous dextro-alprenolol in cardiac arrhythmias. Eur J Clin Pharmacol 3, 148–152 (1971). https://doi.org/10.1007/BF00572455
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DOI: https://doi.org/10.1007/BF00572455