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Effect of Landiolol Hydrochloride on Hemodynamics in a Histamine-Induced Shock Model

Masaharu Hirano1, Tatsuaki Okamura2, Tetsuji Nagano3

  • 1Department of Cardiology, Tokyo Medical University, 6-7-1, Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan. m-hirano@tokyo-med.ac.jp.

Drugs in R&D
|June 15, 2021
PubMed

Insights

Anaphylactic shock during coronary CT angiography can be treated by increasing doses of epinephrine and glucagon in patients taking beta-blockers. This approach mitigates hemodynamic instability, ensuring patient safety during the procedure.

Area of Science:

  • Cardiology
  • Pharmacology
  • Radiology

Background:

  • Anaphylactic shock is a severe adverse drug reaction to contrast media used in coronary computed tomography angiography.
  • Beta-blockers improve coronary computed tomography angiography imaging by reducing heart rate.
  • Short-acting beta-1 blockers are often used in this context.

Purpose of the Study:

  • To analyze anaphylactic shock treatment in patients receiving short-acting beta-1 blockers.
  • To investigate the efficacy of epinephrine and glucagon in managing hemodynamic changes during beta-blocker treatment.

Main Methods:

  • A dog histamine shock model was utilized to simulate anaphylactic shock.
  • The effects of landiolol hydrochloride (a beta-1 blocker) on hemodynamics were assessed.
  • The influence of epinephrine and glucagon on hemodynamic parameters during landiolol treatment was examined.

Main Results:

  • Landiolol decreased mean blood pressure and heart rate, and reduced histamine-mediated increases in cardiac contraction force.
  • Histamine shock led to hemodynamic deterioration in subjects receiving landiolol.
  • Increasing doses of epinephrine and glucagon effectively ameliorated the shock-induced hemodynamic deterioration.

Conclusions:

  • Elevated doses of epinephrine and glucagon can mitigate hemodynamic deterioration from anaphylactic shock in patients on landiolol for coronary computed tomography angiography.
  • Clinicians should ensure adequate supplies of epinephrine and glucagon are available before performing coronary computed tomography angiography.
Abstract

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