![Page 1: BETABLOQUEADORES. RECEPTORES ADRENERGICOS DOWNREGULATION](https://reader033.vdocuments.pub/reader033/viewer/2022061604/5665b4611a28abb57c910ba5/html5/thumbnails/1.jpg)
BETABLOQUEADORES
![Page 2: BETABLOQUEADORES. RECEPTORES ADRENERGICOS DOWNREGULATION](https://reader033.vdocuments.pub/reader033/viewer/2022061604/5665b4611a28abb57c910ba5/html5/thumbnails/2.jpg)
![Page 3: BETABLOQUEADORES. RECEPTORES ADRENERGICOS DOWNREGULATION](https://reader033.vdocuments.pub/reader033/viewer/2022061604/5665b4611a28abb57c910ba5/html5/thumbnails/3.jpg)
RECEPTORES ADRENERGICOS
![Page 4: BETABLOQUEADORES. RECEPTORES ADRENERGICOS DOWNREGULATION](https://reader033.vdocuments.pub/reader033/viewer/2022061604/5665b4611a28abb57c910ba5/html5/thumbnails/4.jpg)
DOWNREGULATION
![Page 5: BETABLOQUEADORES. RECEPTORES ADRENERGICOS DOWNREGULATION](https://reader033.vdocuments.pub/reader033/viewer/2022061604/5665b4611a28abb57c910ba5/html5/thumbnails/5.jpg)
1
2
1
2
3
Vasoconstricción
Retención urinaria
Midriasis
Efecto simpaticolitico
Insulina
Vasoconstricción
Fase IV Disminuye P. refractario aporte O2 – Consumo O2
Renina
Vasopresina
Broncodilatación
Vasodilatación
Glucogenolisis - Gluconeogenesis
Glucagon - Insulina
Temblor – Recaptura de potasio
Ansiedad – Memoria – Regulacion de laliberación de catecolaminas
Lipólisis
![Page 6: BETABLOQUEADORES. RECEPTORES ADRENERGICOS DOWNREGULATION](https://reader033.vdocuments.pub/reader033/viewer/2022061604/5665b4611a28abb57c910ba5/html5/thumbnails/6.jpg)
1
2
Fase IV Disminuye P. refractario aporte O2 – Consumo O2
Renina
Vasopresina
Broncodilatación
Vasodilatación
Glucogenolisis - Gluconeogenesis
Glucagon - Insulina
Temblor – Recaptura de potasio
Ansiedad – Memoria Liberación de catecolaminas
Vasoconstricción1
11- - 22 No selectivos No selectivos•Propranolol•Pindolol•Nadolol
1 Selectivos (11> > 22 )
•Atenolol•Metoprolol•Esmolol•Bisoprolol•Acebutolol•Nebivolol
1- 2- 1
•Labetalol•Carvedilol
EFECTO ESTABILIZADORDE MEMBRANAEFECTO ISA
LIPOSOLUBILIDADEFECTOS ADICIONALES
![Page 7: BETABLOQUEADORES. RECEPTORES ADRENERGICOS DOWNREGULATION](https://reader033.vdocuments.pub/reader033/viewer/2022061604/5665b4611a28abb57c910ba5/html5/thumbnails/7.jpg)
Kalinowsky et al. Circulation 2003;107;2747-2752
![Page 8: BETABLOQUEADORES. RECEPTORES ADRENERGICOS DOWNREGULATION](https://reader033.vdocuments.pub/reader033/viewer/2022061604/5665b4611a28abb57c910ba5/html5/thumbnails/8.jpg)
FARMACOCINETICA
![Page 9: BETABLOQUEADORES. RECEPTORES ADRENERGICOS DOWNREGULATION](https://reader033.vdocuments.pub/reader033/viewer/2022061604/5665b4611a28abb57c910ba5/html5/thumbnails/9.jpg)
CONTRAINDICACIONES / INTERACCIONES
• Bradicardia / Bloqueo AV completo
• ICC Descompensada
• Asma / EPOC
• EVP
• Depresión
• Diabetes
• Síndrome de retirada (Clonidina) – Feocromocitoma - Cocaina
• Farmacocinéticas: Absorción - Metabolismo
• Farmacodinámicas: Verapamilo - AINEs
![Page 10: BETABLOQUEADORES. RECEPTORES ADRENERGICOS DOWNREGULATION](https://reader033.vdocuments.pub/reader033/viewer/2022061604/5665b4611a28abb57c910ba5/html5/thumbnails/10.jpg)
1
REMODELACION MIOCARDICA
![Page 11: BETABLOQUEADORES. RECEPTORES ADRENERGICOS DOWNREGULATION](https://reader033.vdocuments.pub/reader033/viewer/2022061604/5665b4611a28abb57c910ba5/html5/thumbnails/11.jpg)
![Page 12: BETABLOQUEADORES. RECEPTORES ADRENERGICOS DOWNREGULATION](https://reader033.vdocuments.pub/reader033/viewer/2022061604/5665b4611a28abb57c910ba5/html5/thumbnails/12.jpg)
1
![Page 13: BETABLOQUEADORES. RECEPTORES ADRENERGICOS DOWNREGULATION](https://reader033.vdocuments.pub/reader033/viewer/2022061604/5665b4611a28abb57c910ba5/html5/thumbnails/13.jpg)
15 países341 centros1996 - 2002
FE < 35%Hospitalización en los últimos 2 años
3,125 25mg
5 50mg
Carvedilol
Metoprolol
![Page 14: BETABLOQUEADORES. RECEPTORES ADRENERGICOS DOWNREGULATION](https://reader033.vdocuments.pub/reader033/viewer/2022061604/5665b4611a28abb57c910ba5/html5/thumbnails/14.jpg)
![Page 15: BETABLOQUEADORES. RECEPTORES ADRENERGICOS DOWNREGULATION](https://reader033.vdocuments.pub/reader033/viewer/2022061604/5665b4611a28abb57c910ba5/html5/thumbnails/15.jpg)
![Page 16: BETABLOQUEADORES. RECEPTORES ADRENERGICOS DOWNREGULATION](https://reader033.vdocuments.pub/reader033/viewer/2022061604/5665b4611a28abb57c910ba5/html5/thumbnails/16.jpg)
Carvedilol mejor Metoprolol mejor
![Page 17: BETABLOQUEADORES. RECEPTORES ADRENERGICOS DOWNREGULATION](https://reader033.vdocuments.pub/reader033/viewer/2022061604/5665b4611a28abb57c910ba5/html5/thumbnails/17.jpg)
![Page 18: BETABLOQUEADORES. RECEPTORES ADRENERGICOS DOWNREGULATION](https://reader033.vdocuments.pub/reader033/viewer/2022061604/5665b4611a28abb57c910ba5/html5/thumbnails/18.jpg)
Mortalidad anual Carvedilol (COMET): 8.3%Metoprolol (COMET): 10% 85 mg Metoprolol tartrato (50%): 42.5mg/dMetoprolol (MERIT-HF):: 7.2% 159 mg Metoprolol Succinato (35%): 60mg/dBisorprolol (CIBIS-II): 8.8%
![Page 19: BETABLOQUEADORES. RECEPTORES ADRENERGICOS DOWNREGULATION](https://reader033.vdocuments.pub/reader033/viewer/2022061604/5665b4611a28abb57c910ba5/html5/thumbnails/19.jpg)