[Anti-obstructive anti-inflammatory therapy: no problems in pneumology, problematic in cardiology?].
BACKGROUND
Treatment options for bronchial asthma and chronic obstructive pulmonary disease (COPD) are similar and can achieve adequate improvement or even control of symptoms with a relatively low risk of side effects. CARDIOVASCULAR SIDE EFFECTS OF BETA-AGONISTS: However, cardiovascular co-morbidities which increase with age lead to an increasing prevalence of therapy-related side effects especially when long- and short-acting beta 2-agonists and theophylline are being used. Both drugs can also mediate unwanted side effects on the heart. They increase heart rate and contractile properties as well as arrhythmias and the QT-interval and have been associated with myocardial infarction. In addition, their influence on serum potassium levels can be problematic and have the potential to increase side effects of other drugs.
In order to minimize cardiovascular side effects partial beta-agonists appear to have advantages over full agonists as do inhaled preparations compared to oral administration. While beta-adrenergic antiobstructive therapy administered in therapeutic doses is safe in patients without cardiac comorbidities, their use should be limited to the smallest effective dose in patients with cardiac diseases.
Hauck
Rainer W
RW
Medizinische Abteilung 2, Städtisches Krankenhaus Bad Reichenhall. hauck@krankenhaus-bad-reichenhall.de
Virchow
J Christian
JC
D000318:Adrenergic beta-Agonists / Q000009:adverse effects* / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced*; D001993:Bronchodilator Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004562:Electrocardiography / Q000187:drug effects; D006331:Heart Diseases / Q000139:chemically induced*; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D012307:Risk Factors; D013256:Steroids
D000318:Adrenergic beta-Agonists; D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D013256:Steroids