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Comparison of four beta‐blockers as assessed by 24‐hour ECG recording
Author(s) -
Escoubet Brigitte,
Leclercq JeanFrançois,
MaisonBlanche Pierre,
Poirier JeanMarie,
Gourmel Bernard,
DelhotalLandes Brigitte,
Coumel Philippe
Publication year - 1986
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.1986.55
Subject(s) - nadolol , propranolol , metoprolol , acebutolol , potency , heart rate , medicine , clinical pharmacology , pharmacology , beta (programming language) , anesthesia , chemistry , blood pressure , biochemistry , in vitro , computer science , programming language
β‐Blockers are used as if they were equivalent. With ECG recordings in 42 patients we investigated the effect on sinus heart rate of four β‐blockers given at three successive daily doses. Heart rate was dose‐dependently decreased by all drugs except acebutolol, the effect of which decreased at a higher dosage. The maximal effects of metoprolol, nadolol, and propranolol were similar but the drugs differed in potency (dosage producing 50% of maximal effect, calculated from the dose‐effect relationships; nadolol, 0.3 mg/ day; metoprolol, 120 mg/day; propranolol, 47 mg/day). Similar relationships were found with drug plasma concentrations (concentration producing 50% of maximal effect: nadolol, 3.5 ng/ml; metoprolol, 21 ng/ml; propranolol, 36 ng/ml) and with supine or upright heart rates and blood pressures. However, the drugs were not equivalent: In addition to its greater potency, nadolol differed from propranolol and metoprolol in the slope of its dose‐response curve. We conclude that β‐blockers can be compared by ECG recordings and that nadolol is different from the other β‐blockers without intrinsic sympathomimetic activity. Clinical Pharmacology and Therapeutics (1986) 39, 361–368; doi: 10.1038/clpt.1986.55