Bopindolol, Pindolol, and Atenolol in Patients with Chronic Obstructive Lung Disease

Twelve subjects with chronic obstructive lung disease and a partially reversible obstruction received increasing single doses (1, 2, 4, and 8 mg) of bopindolol, (a new beta 1- and beta 2-adrenoceptor blocking drug with intrinsic sympathomimetic activity), pindolol (7.5, 15, and 30 mg), and atenolol (50 and 100 mg). The actions of the drugs on lung function were assessed by whole-body plethysmography. Pindolol did not influence mean airway resistance (Raw). Bopindolol 1, 2, and 4 mg and atenolol 50 mg also exhibited a neutral effect on mean Raw. Atenolol 100 mg, however, induced a long-lasting increase in mean Raw, which was to a lesser extent the case with bopindolol 8 mg. Six of the 12 subjects tested reacted more sensibly. Increases in Raw of more than 10% were observed with bopindolol 2 mg (1 subject), bopindolol 4 mg (4 subjects), pindolol 30 mg (3 subjects), and atenolol 50 mg (3 subjects). This clearly points toward a potential risk of eventually developing severe bronchospasm with each type of beta-adrenoceptor blocking drug in patients with chronic obstructive lung disease and a reversible component of the bronchial obstruction. Nevertheless it is concluded that beta-adrenoceptor blocking drugs with intrinsic sympathomimetic activity such as bopindolol and pindolol compare favorably with cardioselective agents such as atenolol.