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Current Medicinal Chemistry


ISSN (Print): 0929-8673
ISSN (Online): 1875-533X

Beta-Adrenergic Antagonists: Indications and Potential Immunomodulatory Side Effects in the Critically Ill

Author(s): Reiner Oberbeck and Philipp Kobbe

Volume 16, Issue 9, 2009

Page: [1082 - 1090] Pages: 9

DOI: 10.2174/092986709787581770

Price: $65


Pharmacologic blockade of β-adrenergic receptors is a frequent therapeutic intervention in critically ill patients. Todays strategies predominantly include the treatment of cardiovascular diseases like hypertension and cardiac arrhythmias. Furthermore, β-adrenergic antagonists are routinely used to prevent the catecholamine-induced hypermetabolism in critically ill patients suffering from severe burn injury. In addition to these well known beneficial effects of β-adrenoceptor blocking agents it has been demonstrated, that the adrenergic system is involved in the modulation of cellular immune functions. Therefore, the immunomodulatory properties of β-adrenergic antagonists have been established during the last years and the scientific focus was addressed on the proposed immunologic side effects of a β-adrenergic blockade and its potential effect on the clinical course of critical illness. This manuscript reviews the rational and the effect of the therapeutic use of β-adrenergic antagonists in critically ill patients on the base of the current literature and further emphasizes on potential immunologic side effects.

Keywords: Propranolol, β-blocker, adrenergic antagonist, immune system, critical illness, endocrine-immune interaction, critical care medicine

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