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Side effects and contraindications of beta-receptor blocking agents

Nebenwirkungen der β-Receptorenblocker

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Zusammenfassung

Unerwünschte Wirkungen einer Blockade der adrenergen β-Receptoren lassen sich in drei Kategorien einteilen:

  1. 1.

    Nebenwirkungen, die eindeutig und spezifisch aus der primären pharmakologischen, d.h. der β-blokkierenden Wirkung dieser Pharmaka abzuleiten sind

  2. 2.

    Nebenwirkungen, die nicht direkt (oder zumindest nicht mit Sicherheit) auf die β-blockierende Wirkung zurückzuführen sind sowie

  3. 3.

    Nebenwirkungen, die mit hoher Wahrscheinlichkeit spezifisch mit individuellen β-Receptorenblockern verknüpft sind.

In Kategorie 1 fällt die Mehrheit der Nebenwirkungen (Herzinsuffizienz, schwere Bradycardie und Hypotension, arterielle Durchblutungsstörungen, Erhöhung des Atemwegswiderstandes, gastrointestinale Symptome, Hypoglycämie). Sie lassen sich weitgehend durch richtige Auswahl bzw. Vorbereitung der Patienten für diese Therapie vermeiden. In die zweite fallen die Hautreaktionen (Erythem, Alopecie, Juckreiz), thrombozytopenische und nichtthrombozytopenische Purpura sowie Nebenwirkungen, die auf das Zentralnervensystem zu beziehen sind (Schlafstörungen, Alpträume, anxiolytischer Effekt). In die dritte Kategorie wird das „okulocutane Syndrom“ eingereiht, das unter Practolol beobachtet wurde.

Summary

Unwanted effects of beta-receptor blocking agents can be divided into three categories:

  1. 1.

    Those arising specifically from the pharmacologic, i.e. beta-blocking action.

  2. 2.

    Side effects not directly (or not with certainty) related to beta-blockade.

  3. 3.

    Adverse and potentially specific reactions to individual beta-blocking agents.

Category 1 covers the majority of adverse effects (heart failure, severe bradycardia and hypotension, arterial insufficiency, increased airways resistance, gastrointestinal symptoms, hypoglycemia). These can largely be avoided by proper selection and preparation of patients.

Category 2 covers cutaneous reactions (rashes, alopecia, pruritus), purpura (thrombocytopenic and nonthrombocytopenic) etc. as well as side effects attributable to the central nervous system (antianxiety effects, nightmares etc.). In the third category the “oculo-cutaneous syndrome” associated with practolol is discussed.

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    H. Lydtin

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Lydtin, H. Side effects and contraindications of beta-receptor blocking agents. Klin Wochenschr 55, 415–422 (1977). https://doi.org/10.1007/BF01488578

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