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Nebivolol under arrest

Discussion in 'Pharmacy' started by Valery1957, Feb 27, 2019.

  1. Valery1957

    Valery1957 Well-Known Member

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    Resolution of nebivolol-induced coronary vasospasm by intracoronary nitroglycerin during a coronary angiogram.
    Akkus NI, et al. Rev Port Cardiol. 2012.
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    Abstract
    Nebivolol is a novel beta1-selective beta-blocker with vasodilator properties mediated through activation of the l-arginine-nitric oxide pathway. There is no published report of coronary artery spasm associated with nebivolol. We describe a 64-year-old female patient who developed unstable angina secondary to nebivolol-induced vasospastic angina which was also visible during coronary angiography.

    Copyright © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.
    PMID
    23164735 [Indexed for MEDLINE]
     

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  2. Valery1957

    Valery1957 Well-Known Member

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    Nitric oxide mechanisms of nebivolol.
    Review article
    Maffei A, et al. Ther Adv Cardiovasc Dis. 2009.
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    Abstract
    beta-blockers are among the most widely used drugs in the prevention and treatment of cardiovascular disease, although they are associated with increased peripheral resistance. Third-generation beta-blockers avoid this adverse effect by inducing vasodilation through different mechanisms. In particular, nebivolol, a highly selective blocker of beta(1)-adrenergic receptors, is the only beta-blocker known to induce vascular production of nitric oxide, the main endothelial vasodilator. The specific mechanism of nebivolol is particularly relevant in hypertension, where nitric oxide dysfunction occurs. Indeed, nebivolol is able to reverse endothelial dysfunction. Nebivolol induces nitric oxide production via activation of beta(3)-adrenergic receptors, which can explain the good metabolic profile observed after treatment with this drug. Moreover, nebivolol can also stimulate the beta(3)-adrenergic receptor-mediated production of nitric oxide in the heart, and this stimulation can result in a greater protection against heart failure. In conclusion, nebivolol has a unique profile among antihypertensive drugs, adding to a very high selectivity against beta(1) adrenergic receptors, and an agonist action on beta(3) receptors and nitric oxide (NO), which has led to clinically significant improvements in hypertensive patients.

    PMID
    19443516 [Indexed for MEDLINE]
     

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