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Re: provigil+-alpha/beta blocker? mike99

Posted by ed_uk on March 5, 2006, at 14:05:14

In reply to provigil+-alpha/beta blocker? ed_uk, posted by mike99 on March 4, 2006, at 19:24:26

Hi Mike

>The reason I'm concerned about only using a beta blocker w/Provigil is that I've read in the physicians desk reference that beta blockers "increase pressor effects of sympathomimetics"

Beta-1 selective antagonists such as atenolol do not increase the pressor effect of sympathomimetics, the caution applies to non-selective beta blockers such as propranolol.

>For example, based on this premise I believe the protocol for cocaine/amphetamine toxicity in the ER is to never give a beta blocker alone but a mixed alpha/beta antagonist.

That's right. Alpha blockers are needed for the hypertension. Propranolol alone could be risky. A beta-1 selective antagonist (alone) would be safer but wouldn't be adequately effective if severe hypertension was present.

>Do you know if atenolol has any advantages over Toprol?

In the UK, atenolol is cheaper than metoprolol.

Atenolol has a longer duration of action than metoprolol and can be given once or twice daily. Metoprolol often needs to be given several times per day unless it's given as the more expensive Toprol XR.

Very little atenolol enters the brain. Metoprolol, on the other hand, enters the brain more readily. Potential CNS side effects such as sleep disturbances can be a problem.

Kind regards

Ed


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