Rehling M, Svendsen T L, Maltbaek N, Tangø M, Trap-Jensen J
Eur J Clin Pharmacol. 1986;30(6):659-63. doi: 10.1007/BF00608212.
In a double blind, cross over study the haemodynamic effects of an i.v. infusion of adrenaline during concomitant administration of atenolol, pindolol, propranolol or placebo were examined in 7 healthy volunteers. During coadministration with placebo, adrenaline caused an increase in systolic blood pressure (SBP) of 26 mm Hg and a decrease in diastolic blood pressure (DBP) of 20 mm Hg. Heart rate (HR) and stroke volume (SV) were increased by about 20-30%. Total peripheral resistance (TPR) fell significantly. When the subjects were pretreated with atenolol, the adrenaline increased SBP by 16 mm Hg, the DBP did not change, HR and SV increased by 19 and 30%, and TPR fell. During concomitant administration of the non-selective betablocker pindolol, which has strong intrinsic sympathomimetic activity (ISA), adrenaline increased SBP by 11 mm Hg and DBP by 17 mm Hg. This pure pressor response led to a significant reduction in HR and SV and an increase in TPR, probably mediated through the baroreceptors. The haemodynamic response to adrenaline during coadministration of propranolol was very similar to that seen after pindolol. It is concluded that a beta1-selective blocker interferes very little with the haemodynamic response to adrenaline, whereas it is changed to a pure pressor response during coadministration of a non-selective betablockers. ISA did not significantly modify the pressor response.
在一项双盲交叉研究中，对7名健康志愿者在同时给予阿替洛尔、吲哚洛尔、普萘洛尔或安慰剂期间静脉输注肾上腺素的血流动力学效应进行了检查。在与安慰剂合用时，肾上腺素使收缩压（SBP）升高26 mmHg，舒张压（DBP）降低20 mmHg。心率（HR）和每搏输出量（SV）增加约20% - 30%。总外周阻力（TPR）显著下降。当受试者用阿替洛尔预处理时，肾上腺素使SBP升高16 mmHg，DBP不变，HR和SV分别升高19%和30%，TPR下降。在同时给予具有强内在拟交感活性（ISA）的非选择性β受体阻滞剂吲哚洛尔期间，肾上腺素使SBP升高11 mmHg，DBP升高17 mmHg。这种单纯的升压反应导致HR和SV显著降低以及TPR升高，可能是通过压力感受器介导的。在同时给予普萘洛尔期间对肾上腺素的血流动力学反应与在吲哚洛尔之后观察到的非常相似。得出的结论是，β1选择性阻滞剂对肾上腺素的血流动力学反应干扰很小，而在与非选择性β受体阻滞剂合用时则转变为单纯的升压反应。ISA并未显著改变升压反应。
