Influence of the beta-1 selective blocker, metoprolol, on the development of pulmonary edema in tocolytic therapy.
Research on one group of nine anesthetized dogs pretreated with alpha-naphthyl-thiourea showed that doses of the beta-sympathicomimetic fenoterol such as those normally administered in clinical tocolysis (2 micrograms/kg per minute) lead to significant fluid displacement to the extravascular space of the lung in the sense of a preclinical interstitial edema. In a second group (N = 9) with the same pretreatment the addition of the beta-1 selective blocker, metoprolol (1.5 micrograms/kg per minute) served to antagonize the hemodynamic changes and possibly the increase of pulmonary capillary permeability induced by the beta-mimetic. Fluid displacement into the interstitium of the lung was prevented by metoprolol. These observations corroborate the hypothesis that pulmonary edema occurring during tocolytic therapy is largely a result of the use of beta-mimetics. In addition to its cardioprotective effect, the administration of the beta-1 selective blocker, metoprolol, may reduce the risk of the development of pulmonary edema in beta-sympathicomimetic therapy for premature labor.
D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D002199:Capillary Permeability / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D004285:Dogs; D005260:Female; D005280:Fenoterol / Q000627:therapeutic use; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008790:Metoprolol / Q000494:pharmacology / Q000627:therapeutic use*; D007752:Obstetric Labor, Premature / Q000188:drug therapy* / Q000503:physiopathology; D011247:Pregnancy; D011651:Pulmonary Artery / Q000187:drug effects; D011654:Pulmonary Edema / Q000517:prevention & control*; D013566:Sympathomimetics / Q000009:adverse effects; D014655:Vascular Resistance / Q000187:drug effects
D013566:Sympathomimetics; D005280:Fenoterol; D008790:Metoprolol