van Herwaarden C L
J Cardiovasc Pharmacol. 1983;5 Suppl 1:S46-50. doi: 10.1097/00005344-198300051-00007.
Pulmonary function can be reduced by beta-blockers. It has been established that no beta-blocker is entirely safe in patients with chronic obstructive lung disease. An alternative medication not expected to influence pulmonary function should first be considered. This side effect of beta-blockers develops mostly in patients with reversible bronchial obstruction, and it is much less pronounced in those with irreversible bronchial obstruction. Translated into terms of clinical diagnosis, this means that problems should be expected in patients with bronchial asthma and with asthmatic bronchitis, whereas those with chronic bronchitis and emphysema are much less likely to develop relevant symptoms. It has been demonstrated that beta-blockers with intrinsic sympathomimetic activity (ISA), such as pindolol, and beta 1-selective blockers have a less marked effect on pulmonary function than nonselective beta-blockers without ISA, such as propranolol. The untoward effect can be compensated by combination with a beta-mimetic agent; this mechanism is most effective during beta 1-selective blockade.
β受体阻滞剂可降低肺功能。现已证实，对于慢性阻塞性肺疾病患者，没有一种β受体阻滞剂是完全安全的。首先应考虑使用预计不会影响肺功能的替代药物。β受体阻滞剂的这种副作用主要发生在具有可逆性支气管阻塞的患者中，而在具有不可逆性支气管阻塞的患者中则不太明显。从临床诊断角度来说，这意味着支气管哮喘和哮喘性支气管炎患者可能会出现问题，而慢性支气管炎和肺气肿患者出现相关症状的可能性要小得多。已经证明，具有内在拟交感活性（ISA）的β受体阻滞剂，如吲哚洛尔，以及β1选择性阻滞剂对肺功能的影响比没有ISA的非选择性β受体阻滞剂，如普萘洛尔，要小。这种不良作用可通过与β激动剂联合使用来弥补；这种机制在β1选择性阻滞期间最为有效。
