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β-Adrenergic Blockers in Systemic HypertensionPharmacokinetic Considerations Related to the Current Guidelines

 

作者: William H. Frishman,   Mamata Alwarshetty,  

 

期刊: Clinical Pharmacokinetics  (ADIS Available online 2002)
卷期: Volume 41, issue 7  

页码: 505-516

 

ISSN:0312-5963

 

年代: 2002

 

出版商: ADIS

 

关键词: Beta adrenoceptor antagonists, pharmacokinetics;Drug interactions;Elderly;Ethnic groups;Hypertension;Smoking

 

数据来源: ADIS

 

摘要:

β-Adrenergic blockade has provided one of the major pharmacotherapeutic advances of the 20th century. β-Blockers are first-line drugs for the management of systemic hypertension, used alone and in combination with other antihypertensive agents. Drugs in the β-blocking class have the common property of blocking the binding of catecholamines to β-adrenergic receptor sites; however, there are significant pharmacodynamic and pharmacokinetic differences between the individual agents that are of clinical importance. Among these differences are the completeness of gastrointestinal absorption, the degree of hepatic first-pass metabolism, lipid solubility, protein binding, brain penetration, concentration within the cardiac tissue, rate of hepatic biotransformation, and renal clearance of drug and/or metabolites. Long-acting formulations of existing β-blockers are currently in use, and ultra-short-acting agents are also available.Age, race, cigarette smoking and concomitant drug therapy can also influence the pharmacokinetics of β-blocking drugs. The wide interpatient variability in plasma drug concentrations observed with β-blockers makes this parameter unreliable in routine patient management. Despite the pharmacokinetic differences among β-blockers, these drugs should always be titrated to achieve the desired individual patient response.

 

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