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Pharmacodynamic Properties of β-Adrenergic Receptor Blocking Drugs in Man

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Summary

β-Adrenergic receptor blocking drugs have been in clinical use for over 10 years, and have allowed pharmacological manipulation of one of the fundamental homeostatic mechanisms of the cardiovascular system. Their cardiac actions, namely a reduction in heart rate, a change in the pattern of left ventricular contraction and prolongation of atrioventricular conduction, are all explicable on the basis of inhibition of adrenergic receptors. Although ‘quinidine-like’ effects and partial agonist activity have been demonstrated pharmacologically, there is no evidence to suggest that they lead to any significant modification of the properties of β-adrenergic receptor blocking drugs given in therapeutic dosage.

In the peripheral vasculature, the presence of adrenergic vasodilator activity has been demonstrated in the splanchnic and myocardial circulations. The use of relatively selective drugs such as practolol has allowed the response to cardiac blockade to be dissociated from these peripheral effects, and has suggested that the actions of non-selective drugs on arterial pressure and cardiac output are mediated by changes in the peripheral vasculature as well as the heart.

Additional factors of haemodynamic importance are a reduction in plasma volume which has been ascribed to altered vasomotor activity in the peripheral circulation, and inappropriate renal sodium handling which may lead to fluid retention in patients with heart disease. The significance of the suppression of renin secretion by propranolol is still not clear, but its use as a pharmacological tool may contribute to an increased understanding of the physiological importance of the renin-angiotensin system.

Adrenergic stimulation also induces important metabolic effects which cannot readily be classified in terms of α - and β-receptor sites with properties similar to those of smooth muscle or heart. Propranolol blocks stimulatory effects on muscle glycolysis, lipolysis and insulin secretion, and an inhibitory effect on growth hormone release, whilst practolol is considerably less effective when doses with equal cardiovascular effects are compared. It seems likely that further understanding of these alterations in metabolic activity will demonstrate the relation between them and local blood flow, thus giving a clearer picture of the overall response of the cardiovascular system to β-adrenergic blockade.

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Reference

  1. Ablad, B.; Brogård, M. and Ek, L.: Pharmacological properties of H56/28, a beta adrenergic receptor antagonist. Acta Pharmacologica et toxicologica 25 (suppl.2): 9(1967).

    PubMed  CAS  Google Scholar 

  2. Abramson, E.A.; Arky, R.A. and Woeber, K.A.: Effects of propranolol on the hormonal and metabolic responses to insulin-induced hypoglycaemia. Lancet 2: 1386(1966).

    PubMed  CAS  Google Scholar 

  3. Aellig, W.H. and Prichard, B.N.C.: Effects of graded doses of practolol on the tachycardia induced by isoprenaline, Valsalva’s manoeuvre and exercise. British Journal of Pharmacology 39: 193P (abstract) (1970).

    PubMed  CAS  Google Scholar 

  4. Ahlquist, R.P.: Study of the adrenotropic receptors. American Journal of Physiology 153: 586 (1948).

    PubMed  CAS  Google Scholar 

  5. Allison, S.P.; Chamberlain, M.J.; Miller, J.E.; Ferguson, R.; Gillett, A.P.; Bemand, B.V. and Sounders, R.A.: Effects of propranolol on blood sugar, insulin, and free fatty acids. Diabetologia 5: 339(1969).

    PubMed  CAS  Google Scholar 

  6. Antonis, A.; Clark, M.L.; Hodge, R.L.; Maloney, M. and Pilkington, T.R.E.: Receptor mechanisms in the hyperglycaemic response to adrenaline in man. Lancet 1: 1135(1967).

    PubMed  CAS  Google Scholar 

  7. Aström, H.: Haemodynamic effects of β-adrenergic blockade. British Heart Journal 30: 44 (1968).

    PubMed  Google Scholar 

  8. Barrett, A.M. and Cullum, V.A.: The biological properties of the optical isomers of propranolol and their effects on cardiac arrhythmias. British Journal of Pharmacology 34: 43 (1968).

    PubMed  CAS  Google Scholar 

  9. Barrett, A.M.: The pharmacology of practolol. Postgraduate Medical Journal 47 (suppl.): 7 (Jan 1971).

    CAS  Google Scholar 

  10. Barrett, A.M. and Nunn, B.: Intrinsic sympathomimetic activity in relation to the precipitation of heart failure by beta adrenoceptive blockade. Archives Internationales de Pharmacodynamie et de Thérapie 189: 168(1971).

    PubMed  CAS  Google Scholar 

  11. Barrett, A.M.: Beta-adrenoceptive antagonists; in Hamer Recent Advances in Cardiology, p.289 (Churchill Livingstone, Edinburgh, London 1973).

    Google Scholar 

  12. Bay, G.; Lund-Larsen, P.; Lorentsen, E. and Sivertssen, E.: Haemodynamic effects of propranolol (Inderal) in acute myocardial infarction. British Medical Journal 1: 141 (1967).

    PubMed  CAS  Google Scholar 

  13. Beck, W.; Barnard, C.N. and Schrire, V.: Heart rate after cardiac transplantation. Circulation 40: 437 (1969).

    PubMed  CAS  Google Scholar 

  14. Bennet, D.; Balcon, R.; Hoy, J. and Sowton, E.: Haemodynamic effects of dextropropranolol in acute myocardial infarction. Thorax 25: 86 (1970).

    PubMed  CAS  Google Scholar 

  15. Bensaid, J.; Sozutek, Y.; Lefévre, M.; Renais, J.; Scébat, L. and Lénègre, J.: Haemodynamic effects of propranolol in normal human subjects. Acta cardiologica 23: 487(1968).

    PubMed  CAS  Google Scholar 

  16. Bensaid, J.; Scébat, L. and Lénègre, J.: Haemodynamic effects of intravenous oxprenolol. Postgraduate Medical Journal (suppl. Nov): 49 (1970).

  17. Berkowitz, W.D.; Wit, A.L. Lau, S.H.; Steiner, C. and Damato, A.N.: The effects of propranolol on cardiac conduction. Circulation 40: 855 (1969).

    CAS  Google Scholar 

  18. Bhatia, M.L.; Shrivastava, S. and Roy, S.B.: immediate haemodynamic effects of a beta adrenergic blocking agent — propranolol — in mitral stenosis, at fixed heart rate. British Heart Journal 34: 638 (1972).

    PubMed  CAS  Google Scholar 

  19. Black, J.W. and Stephenson, J.S.: Pharmacology of a new beta-receptor blocking compound (Nethalide). Lancet 2: 311(1962).

    PubMed  CAS  Google Scholar 

  20. Blackard, W.G. and Hubbell, G.J.: Stimulatory effect of exogenous catecholamines on plasma HGH concentration in the presence of beta adrenergic blockade. Metabolism 19: 547 (1971).

    Google Scholar 

  21. Bloomfield, D.A. and Sowton, E.: Rate-independent effects of propranolol. The differentiation between chronotropic, inotropic, and peripheral vascular responses. Circulation Research 21: 111–243 (1967)

    Google Scholar 

  22. Braunwald, E.; Plauth, W.H.Jr. and Morrow, A.G.: A method for the detection and quantification of impaired sodium excretion: Results of an oral sodium tolerance test in normal subjects, and in patients with heart disease. Circulation 32: 223 (1965).

    PubMed  CAS  Google Scholar 

  23. Braunwald, E.; Sonnenblick, E.H.; Ross, J.Jr.; Glick, G. and Epstein, S.E.: An analysis of the cardiac response to exercise. Circulation Research 20: 1–44(1967).

    Google Scholar 

  24. Braunwald, E.: On the difference between the heart’s output and its contractile state. Circulation 43: 171 (1971).

    PubMed  CAS  Google Scholar 

  25. Brick, I.; Glover, E.; Hutchison, K.J. and Roddie, I.C.: Effects of propranolol on peripheral vessels in man. American Journal of Cardiology 18: 329 (1966).

    PubMed  CAS  Google Scholar 

  26. Brick, I.; Hutchison, K.J.; McDevitt, D.G.; Roddie, I.C. and Shanks, R.G.: Comparison of the effects of ICI 50172 and propranolol in cardiovascular responses to adrenaline, isoprenaline and exercise. British Journal of Pharmacology and Chemotherapy 34: 127(1968).

    CAS  Google Scholar 

  27. Brick, I.; Hutchison, J. and Roddie, I.C.: Beta adrenergic blocking properties of D- and DL propranolol in man. Irish Journal of Medicinal Science 3: 123 (1970).

    CAS  Google Scholar 

  28. Brooks, H.; Banas, J.; Meister, S.; Szucs, M.; Dalen, J. and Dexter, L.: Sotalol-induced β-blockade in cardiac patients. Circulation 42: 99 (1971).

    Google Scholar 

  29. Brunner, H.; Hedwall, P.R.; Maier, R. and Meier, M.: Pharmacological aspects of oxprenolol. Postgraduate Medical Journal (suppl. Nov): 5 (1970).

  30. Buhler, F.R.; Laragh, J.H.; Baer, L.; Vaughan, E.D.Jr. and Brunner, H.R.: Propranolol inhibition of renin secretion. New England Journal of Medicine 287: 1209(1972).

    PubMed  CAS  Google Scholar 

  31. Cerasi, E.; Effendic, S. and Luft, R.: Role of adrenergic receptors in glucose-induced insulin secretion in man. Lancet 2: 301 (1969).

    PubMed  CAS  Google Scholar 

  32. Cerasi, E.; Luft, R. and Effendic, S.: Effect of adrenergic blocking agents on insulin response to glucose infusion in man. Acta Endocrinologica 69: 335(1972).

    PubMed  CAS  Google Scholar 

  33. Choquet, Y.; Capone, R.J.; Mason, D.T.; Amsterdam, EA. and Zetis, R.: Comparison of the beta adrenergic blocking properties and negative inotropic effects of oxprenolol and propranolol in patients. American Journal of Cardiology 29: 257 (abstract) (1972).

    Google Scholar 

  34. Cleaveland, C.R.; Rangno, R.E. and Shand, D.G.: A standardised isoproterenol sensitivity test. The effects of sinus arrhythmia, atropine and propranolol. Archives of Internal Medicine 130: 47 (1972).

    PubMed  CAS  Google Scholar 

  35. Cohn, J.N.: Relationship of plasma volume changes to resistance and capacitance vessel effects of sympathomimetic amines and angiotensin in man. Clinical Science 30: 267 (1966).

    PubMed  CAS  Google Scholar 

  36. Coltart, D.J. and Meldrum, S.J.: The effect of propranolol on the human and canine transmembrane action potential. British Journal of Pharmacology 40: 148P (abstract) (1970).

    Google Scholar 

  37. Coltart, D.J. and Shand, D.G.: Plasma propranolol levels in the quantitive assessment of β-adrenergic blockade in man. British Medical Journal 3: 731 (1970).

    PubMed  CAS  Google Scholar 

  38. Coltart, D.J.; Gibson, D. and Shand, D.G.: Plasma propranolol levels associated with suppression of ventricular ectopic beats. British Medical Journal 1: 490(1971).

    PubMed  CAS  Google Scholar 

  39. Cullhead, I. and Parrow, A.: Acute hemodynamic changes following β-adrenergic blockade in hyperthyroidism. Acta medica Scandinavica 184: 235 (1968).

    Google Scholar 

  40. Cullum, V.A.; Farmer, J.B.; Jack, D. and Levy, G.P.: Salbutamol: a new selective β-adrenoceptive receptor stimulant. British Journal of Pharmacology 35: 141(1969).

    PubMed  CAS  Google Scholar 

  41. Cumming, G.R. and Carr, W.: Hemodynamic response to exercise after propranolol in normal subjects. Canadian Journal of Physiology and Pharmacology 44: 465 (1966).

    PubMed  CAS  Google Scholar 

  42. Cumming, G.R. and Carr, W.: Hemodynamic response to exercise after β-adrenergic and parasympathetic blockade. Canadian Journal of Physiology and Pharmacology 45: 813 (1967).

    PubMed  CAS  Google Scholar 

  43. Cumming, G.R. and Carr, W.: Hemodynamic response to exercise after β-adrenergic blockade with propranolol in patients with mitral valve obstruction. Canadian Medical Association Journal 95: 527(1968).

    Google Scholar 

  44. Cumming, G.R. and Mir, G.H.: Exercise haemodynamics of coarctation of the aorta. Acute effects of propranolol. British Heart Journal 32: 365 (1970).

    PubMed  CAS  Google Scholar 

  45. Dale, H.H.: On some physiological actions of ergot. Journal of Physiology 34: 163 (1906).

    PubMed  Google Scholar 

  46. Davis, J.O.: What signals the kidney to release renin? Circulation Research 28: 301 (1971).

    PubMed  CAS  Google Scholar 

  47. Donoso, E.; Cohn, L.J.; Newman, B.J.; Bloom, H.S.; Stein, W.G.; and Freidberg, C.K.: Effects of propranolol on patients with complete heart block and implanted pacemakers. Circulation 36: 534 (1967).

    PubMed  CAS  Google Scholar 

  48. Dunlop, D. and Shanks, R.G.: Selective blockade of adrenoceptive beta receptors in the heart. British Journal of Pharmacology 32: 201 (1968).

    CAS  Google Scholar 

  49. Eckbert, D.L.; Drabinsky, M.I. and Braunwald, E.: Defective cardiac parasympathetic control in patients with heart disease. New England Journal of Medicine 285: 877 (1971).

    Google Scholar 

  50. Eisalo, A.; Luomanmaki, K. and Heikkila, J.: Haemodynamic effect of Trasicor, a new β-adrenergic blocking agent in hypertensive patients. Acta medica Scandinavica 186: 105 (1969).

    PubMed  CAS  Google Scholar 

  51. Ekblom, B.; Goldbarg, A.N.; Kilbom, A. and Astrand, P.O.: Effects of atropine and propranolol on the oxygen transport system 46, erect exercise. British Medical Journal 1: 213 (1968). during exercise in man. Scandinavian Journal of Clinical and Laboratory Investigation 30: 35 (1972).

    Google Scholar 

  52. Ekelund, L.G.; Melcher, A. and Oroe, L.: Central haemodynamic effects in man of intravenous d-alprenolol during rest and exercise. European Journal of Clinical Pharmacology 3: 198 (1971).

    PubMed  CAS  Google Scholar 

  53. Eliasch, H; Rosén, A. and Scott, H.M.: Systemic circulation response to stress of simulated flight and to physical exercise before and after propranolol blockade. British Heart Journal 29: 671 (1967).

    PubMed  CAS  Google Scholar 

  54. Epstein, S.E.; Robinson, B.F.; Kahler, R.L. and Braunwald, E.: Effects of beta-adrenergic blockade on the cardiac response to maximal and submaximal exercise in man. Journal of Clinical Investigation 44: 1745(1965).

    PubMed  CAS  Google Scholar 

  55. Epstein, S.E. and Braunwald, E.: The effect of β-adrenergic blockade on patterns of urinary sodium excretion. Annals of Internal Medicine 65: 20(1966).

    PubMed  CAS  Google Scholar 

  56. Finegan, R.E.; Marlon, AM and Harrison, D.C.: Circulatory effects of practolol. American Journal of Cardiology 29: 315 (1972).

    PubMed  CAS  Google Scholar 

  57. Fitzgerald, J.D.; Rowlands, D.J.; Howitt, G. and Davies, E.T.L.: Heart rate response to certain physiological manoeuvres; proposed measure of degree of beta adrenergic blockade. British Heart Journal 33: 614 (abstract) (1971).

    PubMed  CAS  Google Scholar 

  58. Fitzgerald, J.D. and O’Donnell, S.R.: A comparison of the haemodynamic effect of propranolol, 4-hydroxypropranolol, and practolol in anaesthetized dogs. British Journal of Pharmacology 45: 207 (1972).

    PubMed  CAS  Google Scholar 

  59. Forsberg, S-A. and Johnson, G.: Haemodynamic effects of propranolol and H56/28 in man — a comparative study of two β-adrenergic receptor antagonists. Acta pharmacologica et toxicologica 25 (suppl. 2): 75 (1967).

    PubMed  CAS  Google Scholar 

  60. Frick, M.H.; Heikkila, J. and Luomanmaki, K.: Haemodynamics of a new β-adrenergic antagonist LB 46 in man. European Journal of Clinical Pharmacology 2: 134(1970).

    CAS  Google Scholar 

  61. Frohlich, E.D.; Tarazi, R.C.; Dustan, H.P. and Page, I.H.: The paradox of beta-adrenergic blockade in hypertension. Circulation 37: 417 (1968).

    PubMed  CAS  Google Scholar 

  62. Furberg, C. and von Schalensee, G.: Beta adrenergic blockade and central circulation during exercise and sitting position in healthy subjects. Acta physiologica Scandinavica 73: 435 (1968).

    PubMed  CAS  Google Scholar 

  63. George, C.F.; Connolly, M.E.; Fenyvesi, T.; Briant, R. and Dollery, C.T.: Intravenously administered isoproterenol sulphate dose-response curves in man. Archives of Internal Medicine 130: 361 (1972).

    PubMed  CAS  Google Scholar 

  64. Gibson, D. and Sowton, E.: Effects of ICI 50172 in man during erect exercise British Medical Journal 1: 213 (1968).

    CAS  Google Scholar 

  65. Gibson, D. and Sowton, E.: The use of beta adrenergic blocking drugs in dysrhythmias. Progress in Cardiovascular Diseases 12: 16 (1969).

    PubMed  CAS  Google Scholar 

  66. Gibson, D.G.; Marshall, J.C. and Lockey, E.: Assessment of proximal tubular sodium reabsorption during water diuresis in patients with heart disease. British Heart Journal 32: 399 (1970).

    PubMed  CAS  Google Scholar 

  67. Gibson, D.G.: Haemodynamic effects of practolol. Postgraduate Medical Journal 47 (suppl. Jan): 95 (1971).

    Google Scholar 

  68. Gibson, D.G. and Coltart, D.J.: Haemodynamic effects of practolol. British Heart Journal 34: 95 (1972).

    PubMed  CAS  Google Scholar 

  69. Glick, G. and Braunwald, E.: Relative roles of the sympathetic and parasympathetic nervous systems in the reflex control of heart rate. Circulation Research 16: 363 (1965)

    PubMed  CAS  Google Scholar 

  70. Glover, W.E. and Hutchison, K.J.: The effect of a β-receptor antagonist (Propranolol) on the cardiovascular response to intravenous infusions of noradrenaline in man. Journal of Physiology 177: 59P (abstract) (1965).

    Google Scholar 

  71. Goldstein, RE.; Hall, C.A. and Epstein, S.E.: Comparison of simultaneously determined inotropic and chronotropic effects of practolol and propranolol. Clinical Research 19: 316 (abstract) (1971).

    Google Scholar 

  72. Graber, J.; Khanna, P.K.; Raphael, M.J.; Steiner, R.E. and Webb-Peploe, M.M.: Effect of cardioselective beta-adrenergic blockade in patients with abnormal left ventricular function. British Heart Journal 33: 615 (abstract) (1971).

    PubMed  CAS  Google Scholar 

  73. Granjean, T. and Rivier, J.L.: Cardio-circulatory effects of β-adrenergic blockade in organic heart disease. British Heart Journal 30: 50 (1968).

    Google Scholar 

  74. Hamer, J. and Fleming, J.: Effect of propranolol on left ventricular work in aortic stenosis. British Heart Journal 29: 871 (1967).

    PubMed  CAS  Google Scholar 

  75. Hamer, J. and Fleming, J.: Action of propranolol on left ventricular contraction when a fall in heart rate is prevented by atropine. British Heart Journal 31: 670(1969).

    PubMed  CAS  Google Scholar 

  76. Hansen, A.P.: The effect of alpha and beta blocking agents on the exercise induced growth hormone release in normal subjects and juvenile diabetics. Diabetologia 7: 484 (abstract) (1972).

    Google Scholar 

  77. Harris, W.S.; Schoenfeld, C.D.; Brooks, R.H. and Weissler, A.M.: Effect of beta adrenergic blockade on the hemodynamic responses to epinephrine in man. American Journal of Cardiology 17: 484 (1966).

    PubMed  CAS  Google Scholar 

  78. Harrison, D.C. and Griffin, J.R.: Metabolic and circulatory responses to selective adrenergic stimulation and blockade. Circulation 34: 218 (1966).

    PubMed  CAS  Google Scholar 

  79. Heifant, R.H.; Herman, M.V. and Gorlin, R.: Abnormalities of left ventricular contraction induced by β-adrenergic blockade. Circulation 43: 641 (1971).

    Google Scholar 

  80. Hutton, I.; Lorimer, A.R.; Hillis, W.S.; McCall, D.; Reid, J.M. and Lawrie, T.D.V.: Haemodynamics and myocardial function after Sotalol. British Heart Journal 34: 787 (1972).

    PubMed  CAS  Google Scholar 

  81. Imhof, P.R.; Blatter, K.; Fucella, L.M. and Turri, M.: Beta blockade and emotional tachycardia: radiotelemetric investigations in ski jumpers. Journal of Applied Physiology 27: 366 (1969).

    PubMed  CAS  Google Scholar 

  82. Imura, H; Kato, Y.; Ikeda, M.; Morimomoto, M.; Yawata, M. and Fukase, M.: Increased plasma levels of growth hormone during infusion of propranolol. Journal of Clinical Endocrinology and Metabolism 28: 1079(1968).

    PubMed  CAS  Google Scholar 

  83. Jenkins, D.J.A.: Propranolol and hypoglycaemia. Lancet 1: 164 (1967).

    PubMed  CAS  Google Scholar 

  84. Jewitt, D.E.; Burgess, P.A. and Shillingford, J.P.: The circulatory effects of practolol (ICI 50172) in patients with acute myocardial infarction. Cardiovascular Research 4: 188 (1970).

    PubMed  CAS  Google Scholar 

  85. Johnsson, G.: The effects of intra-arterially administered propranolol and H56/28 on blood flow in the fore-arm; a comparative study of two β-adrenergic receptor antagonists. Acta pharmacologica et toxicologica 25 (suppl. 2): 63 (1967).

    PubMed  CAS  Google Scholar 

  86. Johnsson, G.; Morrby, A. and Solvell, L.: Potency and time effect relationship in man of propranolol and H56/28. I: Comparative studies after intravenous administration. Acta pharmacologica et toxicologica 25 (suppl 2): 95 (1967).

    PubMed  CAS  Google Scholar 

  87. Johnsson, G.; de Guzman, M.; Bergman, H. and Sannerstedt, R.: The haemodynamic effects of alprenolol and propranolol at rest and during exercise in hypertensive patients. Pharmacologica clinica 2: 34(1969).

    CAS  Google Scholar 

  88. Jose, A.D. and Taylor, R.G.: Autonomic blockade by propranolol and atropine to study intrinsic myocardial function in man. Journal of Clinical Investigation 48: 2019 (1969).

    PubMed  CAS  Google Scholar 

  89. Julius, S.; Pascual, A.V.; Abbrecht, P.H. and London, R.: Effect of β-adrenergic blockade on plasma volume in human subjects. Proceedings of the Society of Experimental Biology and Medicine 140: 982 (1972).

    CAS  Google Scholar 

  90. Kerber, R.E.; Goldman, R.H.; Alderman, E.L. and Harrison, DC: Circulatory responses to β-adrenergic blockade with alprenolol. American Journal of Cardiology 29: 26 (1972).

    PubMed  CAS  Google Scholar 

  91. Lecerof, H. and Malmborg, R.O.: Hemodynamic effects of oxprenolol alone and combined with nitroglycerin in patients with ischaemic heart disease. Acta medica Scandinavica 192: 499 (1972).

    PubMed  CAS  Google Scholar 

  92. Leon, D.F.; Thompson, M.E.; Shaver, J.A. and McDonald, R.H.: Hemodynamic effects of practolol at rest and during exercise. Circulation 45: 46 (1972).

    PubMed  CAS  Google Scholar 

  93. Levine, H.J.; Neill, W.A.; Wagman, R.J.; Krasnow, N. and Gorlin, R.: The effect of exercise on mean left ventricular ejection rate in man. Journal of Clinical Investigation 41: 1050 (1962).

    PubMed  CAS  Google Scholar 

  94. Levy, J.V.: Cardiovascular effects of Pindolol (LB46), a potent beta-receptor antagonist. Journal of Clinical Pharmacology 11: 249 (1971).

    CAS  Google Scholar 

  95. Lewis, C.M.; Brink, A.J.; Theron, M.J. and Kotzé, J.C.N.: β-adrenergic blockade. Hemodynamics and myocardial energy metabolism in patients with ischaemic heart disease. American Journal of Cardiology 21: 846 (1968).

    PubMed  CAS  Google Scholar 

  96. Lish, P.M.; Weikel, J.H. and Dungan, K.W.: Pharmacological and toxicological properties of two new β-adrenergic receptor antagonists. Journal of Pharmacology and Experimental Therapeutics 149: 161 (1965).

    PubMed  CAS  Google Scholar 

  97. Lockhart, A.; Schrijen, F.; Salmon, D.; Andrada, L. and Peslin, R.: Haemodynamic effects of propranolol in chronic lung diseases. Clinical Science 33: 101 (1967).

    PubMed  CAS  Google Scholar 

  98. Lucchesi, B.R. and Whitsitt, L.S.: The pharmacology of beta-adrenergic blocking agents; in Friedberg Current Status of Drugs of Cardiovascular Disease p.20 (Grune and Stratton, New York and London 1969).

    Google Scholar 

  99. Loubatières, A.; Mariani, M.M.; Sorel, G. and Savi, L: The action of beta adrenergic blocking and stimulating agents on insulin secretion. Characterisation of the type of beta receptor. Diabetologia 7: 127(1971).

    PubMed  Google Scholar 

  100. Lund-Larsen, P.G. and Sivertssen, E.: Haemodynamic effects of propranolol (Inderal) and H56/28 (Aptin) in patients with acute myocardial infarction. Acta medica Scandinavica 186: 187 (1969).

    PubMed  CAS  Google Scholar 

  101. Lund-Larsen, P.G.; Sivertssen, E.; Lorentsen, E.; Bay, G. and Hansteen, V.: Hemodynamic effects of β-adrenergic blockade in patients with complete heart block and implanted pacemaker. Acta medica Scandinavica 183: 511 (1968).

    PubMed  CAS  Google Scholar 

  102. Majid, P.A.; Sharma, B.; Saxton, C.; Stoker, J.B. and Taylor, S.H.: Haemodynamic effects of oxprenolol in hypertensive patients. Postgraduate Medical Journal (suppl. Nov): 67 (1970).

  103. Mackintosh, T.F.: Propranolol and hypoglycaemia. Lancet 1: 104 (1967).

    PubMed  CAS  Google Scholar 

  104. Maksud, M.G.; Trinstani, F.E.; Coutts, K.D.; Barboriak, J.J. and Hamilton, L.H.: Effects of propranolol on several physiological responses during orthostatic and exercise stress in male subjects. Canadian Journal of Physiology and Pharmacology 49: 867(1971).

    PubMed  CAS  Google Scholar 

  105. Mason, D.T.; Usefulness and limitations of the rate of rise of ventricular pressure (dp/dt) in the evaluation of myocardial contractility in man. American Journal of Cardiology 23: 516 (1969).

    PubMed  CAS  Google Scholar 

  106. Massara, T. and Camanni, F: Effect of various adrenergic receptor stimulating and blocking agents on human growth hormone secretion. Journal of Endocrinology 54: 195 (1972).

    PubMed  CAS  Google Scholar 

  107. Mellander, S.: Contribution of small vessel tone to the regulation of blood volume and formation of oedema. Proceedings of the Royal Society of Medicine 61: 55 (1968).

    PubMed  CAS  Google Scholar 

  108. Michelakis, A.M. and McAllister, R.G.: The effect of chronic adrenergic receptor blockade on plasma renin activity in man. Journal of Clinical Endocrinology and Metabolism 34: 386 (1972).

    PubMed  CAS  Google Scholar 

  109. Miller, D.W. and Allen, D.O.: Antilipolytic activity of 4-(2 hydroxy-3 isopropylaminopropoxy) acetanilide (practolol). Proceedings of the Society of Experimental Biology and Medicine 136: 715 (1971).

    CAS  Google Scholar 

  110. Mitchell, M.; Suvunrungsi, P. and Sawin, C.T.: Effect of propranolol on the response of serum growth hormone to glucagon. Journal of Clinical Endocrinology and Metabolism 32: 470 (1971).

    PubMed  CAS  Google Scholar 

  111. Mohs, J.M.; Langley, P.E.; Chase, G.R. and Burns, T.W.: In vivo observations on the role of alpha and beta adrenergic receptor sites in human lipolysis. Clinical Research 20: 57 (abstract) (1972).

    Google Scholar 

  112. Morales-Aguilerá, and Vaughan Williams, E.M.: The effects on cardiac muscle of β-receptor antagonists in relation to their activity as local anaesthetics. British Journal of Pharmacology 24: 332 (1965).

    Google Scholar 

  113. Nayler, W.G.: The effect of beta-adrenergic blocking drugs on myocardial function: an explanation at the cellular level. Postgraduate Medical Journal (suppl. Nov): 90 (1970).

  114. Nies, A.S.; McNeil, J.S. and Schrier, R.W.: Mechanism of increased sodium reabsorption during propranolol administration. Circulation 44: 596(1971).

    PubMed  CAS  Google Scholar 

  115. Nordenfelt, I. and Persson, S.: Haemodynamic effects of propranolol and nitroglycerin in normal subjects during sub-maximal exercise. Acta medica Scandinavica 186: 407 (1969).

    PubMed  CAS  Google Scholar 

  116. Paley, H.W.; McDonald, I.G. and Peters, F.W.: Effect of beta-adrenergic suppression on left ventricular response to exercise in man. Circulation 32: 11 167 (abstract) (1965).

    Google Scholar 

  117. Parker, J.O.; West, R.O. and Di Giorgi, S.: Hemodynamic effects of propranolol in coronary heart disease. Amer. J. Cardiol. 21: 11 (1968).

    PubMed  CAS  Google Scholar 

  118. Pickering, T.G.; Gribbin, B.; Petersen, E.S.; Cunningham, D.J.C. and Sleight, P.: Effects of autonomic blockade on the baroreflex in man at rest and during exercise. Circulation Research 30: 177(1972).

    PubMed  CAS  Google Scholar 

  119. Pollack, G.H.: Maximum velocity as an index of contractility in cardiac muscle, Circulation Research 26: 111(1970).

    PubMed  CAS  Google Scholar 

  120. Porte, D.Jr.: Mechanisms for the regulation of serum insulin levels by catecholamines in man. Journal of Clinical Investigation 45: 1057 (abstract) (1966).

    Google Scholar 

  121. Porte, D.: Sympathetic regulation of insulin secretion. Its relation to diabetes mellitus. Archives of Internal Medicine 123: 252 (1969).

    PubMed  CAS  Google Scholar 

  122. Powell, CE. and Slater, I.H.: Blocking of inhibitory adrenergic receptors by a dichloro analog of isoproterenol. Journal of Pharmacology and Experimental Therapeutics 122: 480 (1958).

    PubMed  CAS  Google Scholar 

  123. Price, H.L.; Deutsch, S.; Davidson, I.A.; Clement, A.J.; Behar, M.C. and Epstein, R.M.: Can general anaesthesia produce splanchnic visceral hypoxia by reducing regional blood flow? Anesthesiology 27: 24(1966).

    PubMed  CAS  Google Scholar 

  124. Price, H.L.; Cooperman, L.H. and Warden, J.C.: Control of the splanchnic circulation in man. Circulation Research 21: 333 (1967).

    PubMed  CAS  Google Scholar 

  125. Prichard, B.N.C; Shinebourne, E.; Fleming, J. and Homer, J.: Haemodynamic studies in hypertensive patients treated by oral propranolol. British Heart Journal 32: 236(1970).

    PubMed  CAS  Google Scholar 

  126. Rahn, K.H.; Johnson, C.E. and McNay, J.L.: A comparison of the beta adrenergic blocking effects and influence on sodium excretion of propranolol and MJ 1999. Circulation 37–38: VI–159 (abstract) (1968).

    Google Scholar 

  127. Reale, A.; Imhof, P. and Motolese, M.: Influence of β-adrenergic blockade on immediate haemodynamic effects of angiocardiography. British Heart Journal 29: 761 (1967).

    PubMed  CAS  Google Scholar 

  128. Reale, A.; Nigri, A.; Gioffré, P.A. and Motolese, M.: Effect upon myocardial blood flow in man of beta-blocking agents, isorbide dinitrate, dipyridamole, and their combination. Postgraduate Medical Journal (suppl. Nov): 44 (1970).

  129. Rice, A.J.; Ferguson, R.K.; Delle, M. and Wilson, W.R.: Comparative beta-blocking activities and effects on sodium excretion of sotalol and propranolol. Clinical Pharmacology and Therapeutics 11: 567 (1970).

    PubMed  CAS  Google Scholar 

  130. Rivier, J.L.; Nissiotis, E. and Jaeger, M.: Comparison of immediate haemodynamic effects of three beta adrenergic blocking agents. Postgraduate Medical Journal (suppl. Nov): 44 (1970).

  131. Robertson, R.P. and Porte, D.: Beta-adrenergic mediated insulin responses in normal and diabetic men. Clinical Research 20: 193 (abstract) (1972).

    Google Scholar 

  132. Robin, E.; Cowan, C.; Puri, P.; Ganguly, S.; deBoyrie, E.; Martinez, M.; Stock, T. and Bing, R.J.: A comparative study of nitroglycerine and propranolol. Circulation 36: 175 (1967).

    PubMed  CAS  Google Scholar 

  133. Robinson, B.F.; Epstein, S.E.; Beiser, C.D. and Braunwald, E.: Control of the heart rate by the autonomic nervous system: studies in man between baro-receptor mechanisms and exercise. Circulation Research 19: 400 (1966).

    PubMed  CAS  Google Scholar 

  134. Robison, G.A.; Butcher, R.W. and Sutherland, E W.: in Cyclic AMP. (Academic Press, New York and London 1971).

    Google Scholar 

  135. Ross, G. and Jorgenson, C.R.: Effects of a cardioselective β-adrenergic blocking agent on the heart and coronary circulation. Cardiovascular Research 4: 148 (1970).

    PubMed  CAS  Google Scholar 

  136. Ross, G.: Panel Discussion. Advances in adrenergic beta-receptor therapy. Postgraduate Medicine Journal (suppl. 47): 109 (Jan 1971).

  137. Ross, J.Jr.; Linhart, J.W. and Braunwald, E.: Effects of changing heart rate in man by electrical stimulation of the right atrium. Circulation 32: 549 (1965).

    PubMed  Google Scholar 

  138. Sannerstedt, R.; Julius, S. and Conway, J.: Hemodynamic response to tilt and beta adrenergic blockade in young patients with borderline hypertension. Circulation 42 1057 (1970).

    PubMed  CAS  Google Scholar 

  139. Sannerstedt, R. and Julius, S.: Systemic haemodynamics in borderline arterial hypertension: responses to static exercise before and under the influence of propranolol. Cardiovascular Research 6: 398 (1972).

    PubMed  CAS  Google Scholar 

  140. Schulman, C.L.; Sulit, Y.Q.M.; Leinbach, R.C.; Harthorne, J.W. and Sanders, C.A.: Effect of β-adrenergic blockade on patients with atrial fibrillation. Circulation 36: 11–231 (abstract) (1967).

    Google Scholar 

  141. Sederberg-Olsen, P. and Ibsen, H.: Plasma volume and extracellular fluid volume during long-term treatment with propranolol in essential hypertension. Clinical Science 43: 165 (1972).

    PubMed  CAS  Google Scholar 

  142. Seltzer, H.S.: Drug-induced hypoglycaemia — a review based on 473 cases. Diabetes 21: 955 (1972).

    PubMed  CAS  Google Scholar 

  143. Schermeister, J.; Decot, M.; Hallauer, W. and Willmann, H.: Beta-receptoren und renal hamodyanamik des Menschen. Arzneimittel Forschung 16: 847 (1966).

    Google Scholar 

  144. Shinebourne, E.; Fleming, J. and Hamer, J.: Effects of β-adrenergic blockade during exercise in hypertension and ischaemic heart disease. Lancet 2: 1217(1967).

    PubMed  CAS  Google Scholar 

  145. Shinebourne, E.; Fleming, J. and Hamer, J.: Haemodynamic responses to exercise in hypertension. Place of the sympathetic nervous system evaluated by a new selective beta-adrenergic blocking agent ICI 50172. Cardiovascular Research 2: 379(1968).

    PubMed  CAS  Google Scholar 

  146. Singh, B.H. and Vaughan Williams, E.M.: Local anaesthetic and antiarrhythmic actions of alprenolol relative to its effect on intracellular potentials and other properties of isolated cardiac muscle. British Journal of Pharmacology 38: 749 (1970).

    PubMed  CAS  Google Scholar 

  147. Singh, B.H; Till, M. and Kelly, D.T.: Effects of oxprenolol (Trasicor, Ciba 39089 Ba) on patterns of urinary sodium excretion in man. American Journal of Cardiology 27: 372 (1971).

    PubMed  CAS  Google Scholar 

  148. Sirtori, C.R.; Azarnoff, D.L. and Shoeman, D.W.: Dissociation of the metabolic and cardiovascular effects of the beta-adrenergic blocker practolol. Pharmaceutical Research Communication 4: 123 (1972).

    CAS  Google Scholar 

  149. Smithen, C.S.; Balcon, R. and Sowton, E.: Use of bundle of His potentials to assess changes in atrioventricular conduction produced by a series of beta-adrenergic blocking agents. British Heart Journal.75; 955 (1971).

    Google Scholar 

  150. Smyth, A.J.; Watson, O.; Peel, J.S. and Turner, A.B.: Some haemodynamic effects of LB46. New Zealand Medical Journal 72: 246 (1970).

    PubMed  CAS  Google Scholar 

  151. Sonnenblick, E.H.; Braunwald, E.; Williams, J.F. and Glick, G.: Effects of exercise on myocardial force velocity relations in intact unanaesthetised man. Relative roles of changes in heart rate, sympathetic activity and ventricular dimensions. Journal of Clinical Investigation 44: 2051 (1965).

    PubMed  CAS  Google Scholar 

  152. Sonnenblick, E.H.; Morrow, A.G. and Williams, J.F.: Effects of heart rate on the dynamics of force development in the intact human ventricle. Circulation 33: 945 (1966).

    PubMed  CAS  Google Scholar 

  153. Sowton, E. and Hamer, J.: Hemodynamic changes after beta-adrenergic blockade. American Journal of Cardiology 18: 317 (1966).

    PubMed  CAS  Google Scholar 

  154. Sowton, E.; Balcon, R.; Cross, D. and Frick, H.: Haemodynamic effects of ICI 50172 in ischaemic heart disease. British Medical Journal 1: 215 (1968).

    PubMed  CAS  Google Scholar 

  155. Stannard, M. and Sloman, G.: Haemodynamic effects of propranolol. British Medical Journal 1: 700(1967).

    Google Scholar 

  156. Svedmyr, N.; Malmberg, R. and Haggendal, E.: The haemodynamic effects of sotalol (MJ 1999) and propranolol in man. Pharmacologia clinica 2: 82 (1970).

    CAS  Google Scholar 

  157. Tarazi, R.C.; Frohlich, E.D. and Dustan, H.P.: Plasma volume changes with long-term beta-adrenergic blockade. American Heart Journal 82: 770(1971).

    PubMed  CAS  Google Scholar 

  158. Tsolakas, T.C.; Davies, J.P.H and Oram, S.: Effects of β-adrenergic blocking agent on the pulmonary circulation in mitral stenosis. Lancet 2: 416 (1965).

    PubMed  CAS  Google Scholar 

  159. Ulrych, M.: Haemodynamic effects of a new beta-adrenergic blocker Trasicor in man when supine and sitting. Pharmacologica Clinica 1: 95 (1968).

    Google Scholar 

  160. Ulrych, M.; Frohlich, E.D.; Dustan, H.P. and Page, I.H.: Immediate hemodynamic effects of β-adrenergic blockade with propranolol in normotensive and hypertensive man. Circulation 37: 411 (1968).

    PubMed  CAS  Google Scholar 

  161. Vaughan Williams, E.M.: Mode of action of beta-receptor antagonists on cardiac muscle. American Journal of Cardiology 18. 399(1966).

    Google Scholar 

  162. Vaughan Williams, E.M. and Papp, J.G.: The effect of oxprenolol on cardiac intracellular potentials in relation to its anti-arrhythmic, local anaesthetic and other properties. Postgraduate Medical Journal (suppl.Nov): 22(1970).

  163. Wasserman, A.J.; Proctor, J.D.; Allen, F.J. and Kemp, V.E.: Human cardiovascular effects of alprenolol, a beta-adrenergic blocker: haemodynamic, anti-arrhythmic and antianginal. Journal of Clinical Pharmacology 10 37(1970).

    CAS  Google Scholar 

  164. Wiener, L.; Stout, B.D. and Cox, J.W.: Influence of β-sympathetic blockade (propranolol) on the hemodynamics of hyperthyroidism. American Journal of Medicine 46: 227 (1969).

    PubMed  CAS  Google Scholar 

  165. Wiener, L.; Dwyer, E.M.Jr. and Cox, J.W.: Hemodynamic effects of nitroglycerine, propranolol, and their combination in coronary heart disease. Circulation 39: 623 (1969).

    PubMed  CAS  Google Scholar 

  166. Wilson, D.F.; Watson, O.F.; Peel, J.S.; Langley, R.B. and Turner, A.S.: Some haemodynamic effects of Trasicor (CIBA 39089Ba). New Zealand Medical Journal 68: 145 (1968).

    PubMed  CAS  Google Scholar 

  167. Wilson, W.R.; Theilen, E.D.; Hege, J.H. and Valenca, M.R.: Effects of beta-adrenergic blockade in normal subjects before, during, and after tri-iodothyronine induced hypermetabolism. Journal of Clinical Investigation 45: 1159 (1966).

    PubMed  CAS  Google Scholar 

  168. Winer, N.; Chokshi, D.S.; Yoon, M.S. and Freedman, A.D.: Adrenergic receptor mediation of renin secretion. Journal of Clinical Endocrinology and Metabolism 29: 1168 (1969).

    PubMed  CAS  Google Scholar 

  169. Wolfson, S.; Heinle, R.A.; Herman, M.V.; Kemp, H.G; Sullivan, J.M. and Gorlin, R.: Propranolol and angina pectoris. American Journal of Cardiology 18: 345 (1968).

    Google Scholar 

  170. Wolfson, S. and Gorlin, R.: Cardiovascular pharmacology of propranolol in man. Circulation 40: 501 (1969).

    PubMed  CAS  Google Scholar 

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    D. G. Gibson

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Gibson, D.G. Pharmacodynamic Properties of β-Adrenergic Receptor Blocking Drugs in Man. Drugs 7, 8–38 (1974). https://doi.org/10.2165/00003495-197407010-00002

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