beta blockers

Started by sosoo
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sosoo

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hi, i wonder if someone can tell me why beta blockers with ISA are important? what use is having ISA property for drugs like pindolol/acebutolol? im guessing intrinsic sympathomimetic will have something to do with noradrenaline, but i cant figure out what.
 
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I doubt this is homework (do you people actually get homework in pharmacy school?). Anyways, I was thinking about this the other day. A quick google search pulled up many sources saying basically this:

The benefits versus disadvantages of ISA have been debated for some time. Despite the possible benefits of ISA, the clinical benefit has not often been demonstrated. In fact, if anything, the presence of ISA carries a negative connotation, particularly given the results of the postmyocardial infarction (MI) survival trials, where beta-blockers without ISA reduced morbidity and mortality. In instances where the use of a beta-blocker is clearly indicated but where the pulse rate is < 60 bpm, however, the use of a beta-blocker with ISA might be indicated.
 
so maybe CHF patients with bradycardia?
 
Beta-blockers with ISA do not reduce resting heart rate, cardiac output or peripheral blood flow. Theoretically better in some patients with HF or sinus bradycardia but does not appear to reduce CV events as well as other beta-blockers.. It may increase risk post-MI or in those with coronary disease so these are r.arely used and have little clinical use.

Source - Dipiro