Use of ß-adrenoceptor antagonists in older patients with chronic obstructive pulmonary disease and cardiovascular co-morbidity: safety issues.
The incidence of and mortality from both chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) increase with age. In addition, the average age of patients with COPD and CVD is also increasing as a result of improvements in both pharmacological and non-pharmacological treatmen...
| Publicado en: | Drugs & Aging Vol. 25; no. 2; pp. 131 - 145 |
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| Autores principales: | , |
| Formato: | review tables/charts Journal Article |
| Publicado: |
Springer Nature
2008
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105740171&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105740171 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1170229X C5B jtl: Drugs & Aging issn: 1170229X maglogo: N pubinfo: dt: 2008 vid: 25 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 105740171 105740171 2009852281 10.2165/00002512-200825020-00005 NLM18257600 105740171 ppf: 131 ppct: 14 formats: fmt: @attributes: type: P tig: atl: Use of ß-adrenoceptor antagonists in older patients with chronic obstructive pulmonary disease and cardiovascular co-morbidity: safety issues. aug: au: Andrus MR Loyed JV affil: Auburn University Harrison School of Pharmacy, Huntsville, Alabama, USA. sug: subj: Adrenergic beta-Antagonists Therapeutic Use Heart Failure Drug Therapy Pulmonary Disease, Chronic Obstructive Drug Therapy Adrenergic beta-Antagonists Adverse Effects Adrenergic beta-Antagonists Pharmacodynamics Adrenergic beta-Antagonists Pharmacokinetics Aged Comorbidity Aged: 65+ years ab: The incidence of and mortality from both chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) increase with age. In addition, the average age of patients with COPD and CVD is also increasing as a result of improvements in both pharmacological and non-pharmacological treatments. Coronary artery disease is a compelling indication for beta-adrenoceptor antagonist use in a population in whom beta-adrenoceptor antagonism is often viewed as contraindicated. beta-Adrenoceptor antagonists have been proven to improve cardiovascular morbidity and mortality but have been under-utilized in patients with COPD with concomitant CVD because of a fear of bronchoconstriction and adverse effects, particularly in the elderly. The advanced age of patients with COPD and CVD, along with the sheer number of patients with these diseases, necessitates that clinicians understand the treatment of these co-morbidities using seemingly conflicting therapy in the form of beta-adrenoceptor agonists and antagonists.We review changes in the pharmacokinetics and pharmacodynamics of beta-adrenoceptor antagonists in the elderly, the role of beta-adrenoceptor antagonists in CVD and the literature regarding the safety and mortality benefits of beta-adrenoceptor antagonists in elderly patients with COPD and concomitant CVD. We conclude that cardioselective beta-adrenoceptor antagonists appear to be safe to use in elderly male patients with mild-to-moderate COPD who have a compelling indication for beta-adrenoceptor antagonist therapy. Data in female patients are very limited. Nonselective beta-adrenoceptor antagonists should be avoided in general, except in patients with heart failure who might benefit significantly from the use of carvedilol. beta-Adrenoceptor antagonists have been shown to improve mortality in older patients with coexisting CVD and COPD. pubtype: Academic Journal doctype: review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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