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Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers01:27

Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers

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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...
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Hypoglycemia and Glucagon01:15

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Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
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Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

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Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
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Oral Hypoglycemic Agents: α-Glucosidase Inhibitors01:19

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α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are...
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Adrenergic Antagonists: ɑ and β-Receptor Blockers01:31

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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...
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Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers01:24

Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers

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Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which...
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Disrupting Reconsolidation of Fear Memory in Humans by a Noradrenergic β-Blocker
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Propranolol induced hypoglycemia.

Amir Horev, Alon Haim, Alex Zvulunov

    Pediatric Endocrinology Reviews : PER
    |May 13, 2015
    PubMed
    Summary

    Systemic propranolol is a first-line therapy for infantile hemangiomas, but can cause hypoglycemia. This review summarizes reports and offers guidelines for preventing this adverse effect in infants.

    Area of Science:

    • Pediatric pharmacology
    • Dermatology
    • Vascular tumor research

    Background:

    • Infantile hemangiomas are the most common vascular tumors in infants.
    • Systemic propranolol has been the primary treatment since 2008, leading to increased usage.
    • Hypoglycemia is a recognized adverse effect of propranolol therapy.

    Purpose of the Study:

    • To review reported cases of hypoglycemia associated with propranolol treatment for infantile hemangiomas.
    • To provide evidence-based guidelines for preventing hypoglycemia in infants receiving propranolol.

    Main Methods:

    • Literature review of studies reporting hypoglycemia in infants treated with propranolol.
    • Analysis of case reports and clinical data.
    • Synthesis of findings to develop prevention strategies.

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    Main Results:

    • Summarized documented instances of symptomatic hypoglycemia.
    • Identified risk factors and clinical presentations of hypoglycemia.
    • Established a framework for monitoring and management.

    Conclusions:

    • Propranolol therapy for infantile hemangiomas requires careful monitoring for hypoglycemia.
    • Implementing preventative guidelines can mitigate the risk of adverse events.
    • Further research may refine management protocols for this common pediatric condition.