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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Within the last 10 years the indications for a therapeutic regimen with beta-blocking-agents have been differentiated: coronary heart disease with angina pectoris (interval regimen), essential hypertension, especially in younger persons; hyperkinetic heart syndrome; thyreotoxikosis, symptomatic therapy; heart rhythm disorders, extrasystolic or tachysystolic; neurologic-psychiatric diseases. The development of the newer beta-blocking-agents has effected different kinetic data (f.i. long acting effects of Tenormin) and a increased cardioselectivity. The recommendations for the therapeutic regimen have to be outlined to the underlying diseases. The sensitivity against the drugs depends on remarkable individual differences, with the consequence of a careful and low dosage in the beginning in each case. The side-effects of beta-blocking-agents are presumably: bradycardia, bronchospasm, fatigue, adynamia, myocardial insufficiency, gastrointestinal symptoms, hypoglycemia, hypotension.
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PMID:[Therapy with beta-blocking-agents (author's transl)]. 3 43

1 Thirteen men with untreated essential hypertension in WHO stage I were studied on an outpatient basis to evaluate the haemodynamic long-tern effect of a new beta-adrenoceptor blocker, atenolol. 2 Oxygen consumption, heart rate, cardiac output (Cardiogreen) and intraarterial branchial pressure were recorded at rest in a supine and sitting position and during steady state work at 300, 600 and 900 kpm/min. 3 The subjects were treated with atenolol (dose 100-200 mg/day) as the sole drug for 1 year and the haemodynamic study was repeated. 4 The blood pressure was reduced approximately 18% both at rest and during exercise, the heart rate approximately 25% and the cardiac output 16% at rest supine and 27% at rest sitting. During exercise the reductions in cardiac output were approximately 20%. The calculated total peripheral resistance was not decreased compared to pretreatment values. The mean arterial pressure-heart rate product was reduced almost 40%. 5 Apart from temporary muscular fatigue during the first weeks, no side-effects were seen. 6 Atenolol is an effective blood pressure lowering drug in mild and moderate hypertension, but the drop in blood pressure is associated with marked reduction in heart rate and cardiac output at rest as well as during exercise.
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PMID:Haemodynamic long-term effects of a new beta-adrenoceptor blocking drug, atenolol (ICI 66082), in essential hypertension. 97 71

Celiprolol is a new-generation beta-blocker with ancillary properties that include partial beta 2-agonism and direct vasodilating activity. The effects of atenolol and celiprolol on maximal exercise capacity and on both respiratory variables and subjective indices of breathlessness and fatigue during submaximal exercise were compared in a placebo-controlled crossover study of 12 trained volunteers. Both atenolol and celiprolol equally and significantly reduced exercise capacity and maximal oxygen consumption. During constant submaximal exercise at 70% maximal oxygen uptake, however, differences emerged between the two beta-blockers. Atenolol was associated with a significantly higher minute ventilation than placebo. In contrast, values for minute ventilation and respiratory exchange ratio with celiprolol were similar to values with placebo. During the early stages of exercise, treatment with atenolol was also associated with higher scores for the subjective indices of breathlessness and fatigue. Thus submaximal exercise, which may be physiologically more relevant to the everyday activities of patients, may demonstrate potentially useful differences between drugs that are not seen during maximal exercise testing.
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PMID:Submaximal, but not maximal, exercise testing detects differences in the effects of beta-blockers during treadmill exercise: a study of celiprolol and atenolol. II. 167 Nov 88

1. The differential effects of beta-adrenoceptor subtypes on potassium fluxes and exercise capacity were compared in eight healthy young men using single oral doses of the selective beta 2-adrenoceptor antagonist ICI-118551, the selective beta 1-adrenoceptor antagonist atenolol or the non-selective beta-adrenoceptor antagonist propranolol. The study was randomized, double-blind and placebo controlled. 2. Potassium in the venous effluent from the exercising muscles increased progressively with increasing exercise intensity. This response was augmented by propranolol, whereas neither atenolol nor ICI-118551 modified the response. After exercise potassium concentration fell exponentially with no difference between the treatment regimens. 3. Cumulative work was significantly reduced by ICI-118551 (6.4%, P = 0.04) and by propranolol (12.4%, P less than 0.01), whereas the reduction with atenolol (5.6%) did not reach statistical significance. 4. Atenolol and propranolol reduced peak heart rate by 23% and 29%, and peak systolic blood pressure by 9% and 11% respectively during maximal exercise. ICI-118551 caused a non-significant reduction in heart rate during submaximal exercise, with a significant reduction at maximum exercise (6% reduction), whereas systolic blood pressure was not different from placebo. Diastolic blood pressures were similar across all treatment regimens. 5. Similar glucose concentrations were obtained at baseline and at exhaustion during all treatment regimens. Lactate concentrations were comparable for any given exercise intensity irrespective of treatment regimens. Propranolol reduced lactate concentrations from the exercising muscles at maximum exercise in proportion to the reduction of maximal exercise capacity. 6. The subjective perception of fatigue was not affected by either beta 1- or beta 2-adrenoceptor blockade.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effects of selective beta 2-adrenoceptor blockade on serum potassium and exercise performance in normal men. 168 47

Twenty children and adolescents treated orally with atenolol for chronic paroxysmal ventricular tachycardia (n = 10) or Long QT Syndrome (n = 10) over a 5 year period were retrospectively evaluated to ascertain the efficacy of arrhythmia suppression, the effective dosage, the cardiovascular effects, and the incidence of adverse effects. Patients with paroxysmal ventricular tachycardia were classified by their response to exercise or catecholamines. Atenolol was effective in each patient (n = 5) whose tachycardia was precipitated or exacerbated by exercise or catecholamines when the patient was receiving a dosage of approximately 1.7 mg/kg/day. In those patients (n = 4) in whom exercise or catecholamines either suppressed or had no effect on the tachycardia, none were effectively treated in spite of receiving comparable dosages. Three of these four patients also had structural abnormalities or myocardial dysfunction. Atenolol was effective in treating 4 of 10 patients with long QT syndrome with a dosage of approximately 1.5 mg/kg/day. Six ineffectively treated patients received similar dosages, and four required either additional medication or surgical sympathectomy for persistent syncope. The other two patients died suddenly. Cardiovascular side effects included bradycardia in three patients and hypotension in one. Noncardiovascular effects included mild fatigue (four patients) headache (two), sleep disturbance (two), and difficulty concentrating (one). The medication was discontinued because of side effects in two patients. Atenolol is more likely to be effective in the suppression of paroxysmal ventricular tachycardia in children if the tachycardia is exacerbated by exercise or catecholamines and if the heart is otherwise normal.
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PMID:Atenolol in children with ventricular arrhythmias. 235 17

This study involved 113 patients (mean age 50 +/- 14 years) with diastolic blood pressure above 95 mmHg. The patients abstained from taking any antihypertensive drug and received a placebo for one week before entering felodipine, a new calcium antagonist (5 mg x2/day for 2 weeks, then 10 mg x2/day) or atenolol (100 mg/day). There was no significant difference between the two treatment groups. Atenolol tended to be more effective in young subjects and felodipine in subjects aged 60 years or more. Heart rate was more reduced by atenolol than by felodipine (P less than 0.01). Undesirable side-effects were recorded by means of an open questionnaire. Their incidence was 23 per cent during the week under placebo and 84 per cent and 80 per cent respectively during treatment with felodipine or atenolol. The most frequent side-effects were oedema of the ankles and headache under felodipine, fatigue and headache under atenolol. Alkaline phosphatase levels were higher in the felodipine group (P less than 0.05), and a slight rise in blood potassium level (0.2 mmol/l) was noted in the atenolol group (P = 0.001), but these values remained within normal limits.
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PMID:[Treatment of essential hypertension with felodipine or atenolol as first line therapy. Comparative double-blind randomized study]. 252 34

A randomized cross-over trial was undertaken on 21 occupationally active persons who had a stable mild or moderate hypertension with the purpose of comparing the effect of a beta-adreno-receptor blocking agent (atenolol) with that of a calcium channel inhibitor (nifedipine). The doses recommended by the manufactures were used. Atenolol (100 mg) given once a day resulted in a marked hypotensive effect at rest as well as during exercise, the compliance was satisfactory, and the hemodynamic changes were not reflected in unfavourable side effects during muscular exercise or in the subjects own personal assessment of fatigue during the exercise tests which ranged in energy expenditure from about three to six times the resting level. However, unfavourable, modest side effects occurred in two subjects during atenolol medication to the extent that they wanted to terminate the study. Nifedipine therapy with doses of 10 mg, three times a day, resulted in a modest, but statistically insignificant reduction in arterial blood pressure, which contrasts with previous published results. It is suggested that the modest effect is caused or related to the poor compliance and a daily dose that was quantitatively too small. No unfavourable side effects were seen during muscular efforts when the subjects were on nifedipine medication.
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PMID:Working ability and exercise tolerance during treatment of a mild hypertension. I. Comparison between a beta-adreno-receptor blocking drug and a calcium antagonist. 286 20

The treatments of mild hypertension with atenolol and prazosin in occupationally active men and women were compared in a double blind cross-over with placebo. The hypotensive effect of the beta-adreno-receptor blocking drug, atenolol, were striking and in accordance with current knowledge, using one daily dose of 100 mg. In contrast, the hypotensive effect of taking 2 mg prazosin twice a day was modest, averaging about 3% when compared with placebo, somewhat less but still detectable during the performance of muscular exercises. Atenolol medication significantly reduced heart rate and blood pressure responses to muscular exercises, covering a range of work loads experienced during ordinary working days. No increased feeling of muscular fatigue or other discomfort during muscular work compared to that on prazosin and placebo medication could be detected. It was therefore concluded that atenolol medication was a useful treatment of mild hypertension and did not reduce the normal working ability and exercise tolerance. Prazosin medication did not significantly change working ability and exercise tolerance.
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PMID:Working ability and exercise tolerance during treatment of mild hypertension. II. A comparison between atenolol and prazosin medication. 389 71

Thirty patients with stable angina have been undergone a multistage treadmill test, after a single oral dose of 100 mg of Atenolol, a beta 1 . selective blocking agent, in comparison to a previous test carried out after an identical looking placebo tablet. After placebo all the patients showed ischemic ST segment response (ST depression greater than 1 mm), 25 of them interrupting the test because of anginal pain (20 patients), or of ST depression greater than 3 mm (3 patients), or of ventricular ectopics (one patient), or of fatigue (one patient). After Atenolol 10 patients completed the planned test, 7 of them without ischemic changes of ST. 27 patients (90%) showed increased working capacity with significant reduction of heart-rate (FC), systolic blood pressure (PAS) and their product and of ST depression, either before and during and at the end of exercise. The recovery time of ischemic ECG change has been significantly reduced. The observed increased working capacity is attributed to the reduced myocardial O2 consumption expressed from the reduction of the product FC x PAS. Nevertheless at the end of exercise test after beta-blocking drug this product didn't reach the threshold value at which the test was interrupted in the first test after placebo. The authors discuss the possible cause of this effect of beta-blocking drugs, which could be attributed to a reduction of coronary blood flow and/or to an increased myocardial tension because of increased end diastolic ventricular volume. However the Authors outline that the per cent increases of FC, PAS, and FC x PAS have not been reduced by the Atenolol, unlike their absolute values, at the threshold of angina: the ischemic reveals itself at same levels of per cent increase of the factors of O2 myocardial consumption, the later reaching of threshold values depending on the lower starting values. The advantages of Atenolol as regards the other beta-blocking drugs (better acceptability, stability and duration of action) are outlined too.
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PMID:[Evaluation by exercise test of effects of a single oral dose of atenolol in patients with stable angina (author's transl)]. 704 18