Beta blockers are widely used in the management of cardiac conditions and thyrotoxicosis, and to reduce perioperative complications. Asthma and chronic obstructive pulmonary disease (COPD) have been classic contraindications to the use of beta blockers because of their potential for causing bronchospasm. The identification of cardioselective beta blockers that have significantly greater affinity for beta receptors offers a sub- group of beta blockers that are less likely to cause bronchospasm. Salpeter and associates analyzed data from randomized, blinded, placebo-controlled trials to evaluate the effect of cardioselective beta blockers on patients with reactive airway disease, including asthma or COPD with a reversible component. Eligible studies could use oral or intravenous dosing given as a single dose or as continuous treatment. Of the 29 studies included in this meta-analysis, 19 studied single-dose treatment in a total of 240 patients. The cardioselective beta blockers without intrinsic sympathomimetic activity that were used in the study included atenolol, metoprolol, bisoprolol, and practolol. Elsy Viviana Navas, MDDepartment of Cardiovascular Medicine, Cleveland Clinic David O. Taylor, MDDepartment of Cardiovascular Medicine, Critical Care Center, and Transplantation Center, Cleveland Clinic Address: David O. Taylor, MD, Department of Cardiovascular Medicine, J3, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195; e-mail [email protected] Treatment with beta-adrenergic receptor blockers decreases the mortality rate in patients with coronary artery disease or heart failure, as well as during the perioperative period in selected patients (eg, those with a history of myocardial infarction, a positive stress test, or current chest pain due to myocardial ischemia). The current evidence supports giving beta-blockers to patients with coronary artery disease and chronic obstructive pulmonary disease (COPD) or asthma, which lowers the 1-year mortality rate to a degree similar to that in patients without COPD or asthma, and without worsening respiratory function. However, these data are from small trials in the 1970s and 1980s. On the other hand, not giving beta-blockers can pose a risk of death.
AAAAI experts offer tips on medications that can trigger asthma symptoms. For the treatment of chronic asthma; however, concerns regarding risk. prescribing in patients with asthma and associations with severe. Metoprolol. 58 5.8.