Usporedba farmakoloških svojstava odabranih beta blokatora te razlike u učinkovitosti kod najčešćih kliničkih primjena

master's thesis

• Title (english): Comparison of pharmacological properties of selected beta-blockers and differences in efficacy in the most common clinical applications
• Author: Marin Vučić
• Mentor: Lidija Bach-Rojecky (mentor)
• Committee member: Lidija Bach-Rojecky (predsjednik povjerenstva)
• Committee member: Živka Juričić (član povjerenstva)
• Committee member: Maja Ortner Hadžiabdić (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Department of pharmacology); Zagreb
• Defense date and country: 2018-05-04, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Beta blokatori jedni su od najstarijih lijekova koji djeluju na kardiovaskularni sustav i svakako jedni od najkorištenijih lijekova općenito. Spektar njihove primjene seže od kardiovaskularnih bolesti od kojih su najvažnije arterijska hipertenzija, ishemijske bolesti srca, kronično zatajenja srca sa smanjenom ejekcijskom frakcijom i srčane aritmije pa sve do liječenja i/ ili prevencije migrene i tremora. Iako je njihov osnovni mehanizam djelovanja antagonizam ( blokada) β-adrenergičkih receptora, među njima postoje značajne razlike, kako u farmakokinetičkim svojstvima, tako i u dodatnim farmakodinamskim učincima. Dakle, nije opravdano svim lijekovima iz ove skupine automatski pripisivati svojstva koja su uočena kod pojedinog predstavnika. Zbog toga su se ovim diplomskim radom pokušale objasniti sve razlike koje među njima postoje, kao i razlike u učinkovitosti u liječenju arterijske hipertenzije, ishemijskih bolesti srca, kroničnog zatajenja srca sa smanjenom ejekcijskom frakcijom, srčanim aritmijama, astmi i KOPB-u, šećernoj bolesti tipa 1 i 2 te nekardiološkim stanjima kao što su hipertireoza, migrena i mišićni tremor. U gotovo svim navedenim indikacijama, najkorisniji i najučinkovitiji pokazali se predstavnici treće generacije, nebivolol i karvedilol, a slijede ih bisoprolol, metoprolol i atenolol, selektivni predstavnici druge generacije. S obzirom na njihove korisne učinke u teškim kardiovaskularnim bolestima, ove lijekove treba mudro odabirati i koristiti. Zato bi nova, velika, randomizirana kontrolirana klinička ispitivanja trebala sve više ispitivati i potvrđivati ulogu nebivolola i karvedilola u svim navedenim indikacijama, kao i uspoređivati ishode liječenja u odnosu na druge lijekove s djelovanjem na kardiovaskularni sustav.

Abstract (english)

Beta blockers are one of the oldest drugs that affect functions of the cardiovascular system and certainly one of the most commonly used drugs in general. The spectrum of their application is derived from cardiovascular diseases, most important of which are arterial hypertension, ischemic heart diseases, chronic heart failure with reduced ejection fraction and cardiac arrhythmia up to treatment and / or prevention of migraine and tremors. Although their basic mechanism of action is antagonism (blockade) of β-adrenergic receptors, there are significant differences between them both in pharmacokinetic properties and in additional pharmacodynamic effects. Therefore, it is not justified for any drug in this group to automatically attribute properties observed by a particular representative. For this reason, this thesis attempted to explain all differences between them, as well as differences in efficacy in the treatment of arterial hypertension, ischemic heart diseases, chronic heart failure with reduced ejection fraction, cardiac arrhythmias, asthma and COPD, type 1 and 2 diabetes melitus, and non-cardiac conditions such as hyperthyroidism, migraine and muscular tremor. In most of the aforementioned indications, third-generation drugs, nebivolol and carvedilol are the most useful and effective, followed by bisoprolol, metoprolol and atenolol as second generation cardioselective agents. Given their beneficial effects in severe cardiovascular disease, these medications should be wisely selected and used. Therefore, new, large, randomized, controlled clinical trials should increasingly investigate and confirm the role of nebivolol and carvedilol in all of these indications as well as compare treatment outcomes with other cardiovascular drugs.

• Keywords: beta blokatori; selektivnost; nebivolol; karvedilol; arterijska hipertenzija; kronično zatajenje srca; angina pectoris; fibrilacija atrija
• Keywords (english): beta-blockers; cardioselectivity; nebivolol; carvedilol; arterial hypertension; chronic heart failure; ischemic myocardial diseases; atrial fibrillation
• Language: croatian
• URN:NBN: urn:nbn:hr:163:591379
• Study programme: Title: Pharmacy; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: magistar/magistra farmacije (magistar/magistra farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-01-16 13:21:09