Beta-blockers as therapy for infantile hemangiomas
Harrison P Nguyen1, Brent B Pickrell1, Teresa S Wright2
1Baylor College of Medicine, Houston, Texas.
Seminars in Plastic Surgery
|July 22, 2014
Summary
Propranolol is a safe and effective first-line treatment for infantile hemangiomas (IH), improving most cases rapidly. While generally well-tolerated, rare adverse events like hypoglycemia can occur, particularly with fasting.
Area of Science:
- Pediatric Dermatology
- Vascular Biology
- Pharmacology
Background:
- Infantile hemangiomas (IH) are common pediatric vascular tumors.
- Spontaneous resolution occurs in most cases, but some require treatment for complications.
- Propranolol has become the preferred first-line therapy, replacing corticosteroids.
Purpose of the Study:
- To review the efficacy and safety of propranolol for infantile hemangiomas.
- To highlight the rapid onset of action of propranolol in IH treatment.
- To discuss the adverse event profile associated with propranolol therapy.
Main Methods:
- Literature review of studies on propranolol for infantile hemangiomas.
- Analysis of clinical outcomes and adverse events reported in existing research.
- Comparison of propranolol's safety and efficacy against previous treatments like corticosteroids.
Main Results:
- Propranolol demonstrates rapid and significant improvement in most infantile hemangiomas, often within days.
- It is generally considered safer than systemic corticosteroids.
- Adverse events are infrequent but can include sleep disturbances, acrocyanosis, hypotension, bradycardia, respiratory issues, and hypoglycemia.
Conclusions:
- Propranolol is a highly effective and relatively safe first-line treatment for infantile hemangiomas.
- Awareness of potential adverse events, especially hypoglycemia in fasting infants, is crucial.
- The shift to propranolol represents a significant advancement in IH management.
Related Concept Videos
01:27Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers
1.7K
β-receptor blockers significantly impact the cardiovascular system by counteracting catecholamine-induced sympathetic responses. These medications decrease heart rate, contractility, and cardiac output, potentially leading to cardiac depression, life-threatening bradycardia, and death. Therapeutically, β-blockers function as mild antihypertensives and are utilized in treating angina pectoris and cardiac arrhythmias. However, nonselective β-blockers inhibit β2-receptors in...
1.7K
01:31Adrenergic Antagonists: ɑ and β-Receptor Blockers
1.3K
Third-generation β-blockers, such as labetalol and carvedilol, represent a significant advancement in managing cardiovascular conditions. Unlike conventional β-blockers, which can induce peripheral vasoconstriction, third-generation drugs block α1 adrenoceptors. This promotes vasodilation through several mechanisms, such as increased nitric oxide production, inhibition of calcium ion entry, opening of potassium ion channels, and antioxidant action. Labetalol, for instance, is...
1.3K
01:22Heart Failure Drugs: β-Blockers
2.5K
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
2.5K
01:28Antihypertensive Drugs: Types of β-Blockers
2.0K
β receptors are classified into three subclasses: β1, β2, and β3. β1 receptors are primarily located in the heart and kidneys. When they get activated, they increase heart rate, contractility, and renin release. This process enhances blood pressure and aids in stress management. In contrast, β2 receptors are situated mainly in the lungs, blood vessels, and skeletal muscles. Upon activation, they trigger smooth muscle relaxation, causing bronchodilation and...
2.0K
01:25Adrenergic Antagonists: Chemistry and Classification of β-Receptor Blockers
1.6K
β-adrenergic antagonists, or β-blockers, modulate the sympathetic nervous system by targeting β-adrenoceptors and inhibiting catecholamine-mediated sympathetic responses. β-blockers differ in their adrenoceptor subtype affinity, lipophilicity, and α-blocking capabilities. The history of β-blocker development began with the prototype, dichloroisoprenaline, which exhibited partial agonist activity. As a result, propranolol was developed as a pure antagonist but...
1.6K
01:26Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers
688
Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
688