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Hemodynamic Effects of Flestolol, a Titratable Short‐Acting Intravenous Beta‐Adrenergic Receptor Blocker
Author(s) -
Strom Joel,
Josephson Martin,
Frishman William H.,
Singh Bramah,
Heilbrunn Stephen,
Osterle Stephen,
Turlapaty Prasad,
Viray Rico,
Coe Jessie,
Bell Valerie,
Laddu Atul
Publication year - 1988
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/j.1552-4604.1988.tb03144.x
Subject(s) - hemodynamics , medicine , heart rate , discontinuation , cardiac output , anesthesia , contractility , vascular resistance , cardiology , blood pressure
The hemodynamic effects of flestolol were evaluated in 30 patients undergoing routine cardiac catheterization. Hemodynamic measurements were obtained during baseline (prior to flestolol), at steady state during IV flestolol infusion (1, 5, and 10 μg/kg/min) and at 20 to 30 minutes after discontinuation (postinfusion). Flestolol‐induced hemodynamic changes were similar to those induced by other beta blockers without intrinsic sympathomimetic activity. Significant dose‐dependent reduction in heart rate, rate pressure product, and increase in peripheral vascular resistance were seen. Flestolol produced clinically insignificant decrease in myocardial contractility as shown by slight decrease in LVdp/dt, CI, and LVEF. Hemodynamic data from patients with paced heart rate, further confirms a direct mild cardiac depressant effect of flestolol, a finding common to other beta blockers. Consistent with the short elimination half‐life of flestolol (t 1/2 = 6.5 minutes), most of the hemodynamic changes rapidly returned to preinfusion level within 20 to 30 minutes following its discontinuation. Thus flestolol, with its unique pharmacokinetic profile and titrability, may be beneficial in the treatment of critically ill patients.