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Differences between acute and long‐term metabolic and endocrine effects of oral beta‐adrenoceptor agonist therapy with pirbuterol for cardiac failure.
Author(s) -
CanepaAnson R,
Dawson JR,
Kuan P,
PooleWilson PA,
Sutton GC,
Cockrill B,
Reuben SR
Publication year - 1987
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/j.1365-2125.1987.tb03026.x
Subject(s) - medicine , endocrinology , digoxin , insulin , furosemide , heart failure , agonist , oral administration , stroke volume , receptor , ejection fraction
The metabolic, hormonal and haemodynamic effects of oral pirbuterol, a new beta 2‐adrenoceptor agonist, were studied acutely (n = 19) and after 3 months treatment (n = 11) in patients with severe heart failure receiving chronic frusemide therapy. In the acute study fasted patients (n = 10) showed reductions in plasma K+ (P less than 0.005) and cortisol (P less than 0.01) and increases in plasma glucose (P less than 0.005), insulin (P less than 0.01), lactate (P less than 0.005) and pyruvate (P less than 0.0025). These acute changes were less in unfasted subjects (n = 9). Maximal increase in stroke volume occurred at approximately half the plasma pirbuterol concentration required for maximal effect on plasma insulin. Treatment with pirbuterol for 3 months was associated with sustained increases in stroke volume and fasting plasma glucose and insulin, but there was loss of all other acute metabolic effects. Despite concurrent frusemide and digoxin therapy acute hypokalaemia caused no adverse effects. Hypokalaemia did not occur with chronic pirbuterol administration.