Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P01275 (glucagon)
 26,492 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Beta antagonists competitively block beta 1-adrenoceptors that mediate both the rate and force of myocardial contraction. Their precise mechanism of anti-anginal action is uncertain. A reduction in oxygen demand may relative pain and improve effort tolerance. Alternatively inhibition of the adrenergic drive to contraction may offset the increased ventricular wall tension due to incomplete relaxation. Partial agonist activity in a beta-antagonist does not influence efficacy nor protect against airflow obstruction. Membrane stabilising activity is clinically trivial. Cardioselectivity makes airflow obstruction less likely at low but not at high blood concentrations of drug. Alpha-receptor antagonism may also prevent broncho-constriction; it has not been assessed in coronary vasospasm. The dosage and choice of drugs are based on pharmaco-kinetic and dynamic data in animals and man. The major side-effects of beta-blockade are heart failure and airflow obstruction. Cardiotoxicity from overdosage may be treated with isoprenaline, dopamine or glucagon while beta 2-agonists will reverse bronchoconstriction. Since beta-antagonists raise-peripheral vascular impedance, reduction of preload with nitrates enhances their antianginal efficacy. Combining a beta-antagonist with nifedipine seems especially useful. Beta-blockade is worth trying in angina with normal coronary arteries. In acute coronary insufficiency beta-blockade reduces both the work-load on the heart and the somatic features of anxiety, so preparing patients for investigations, like coronary arteriography, aimed at definitive treatment.
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PMID:Clinical pharmacology of beta-adrenoceptor antagonism in angina pectoris: an overview. 611 11

The effects of a beta 1-selective (metoprolol, 150 mg per day) and a non-selective beta-blocking agent (propranolol, 120 mg per day) on metabolic and hormonal responses to physical exercise (a 30 min bicycle ergometer test) were investigated against placebo in seven healthy male volunteers with a double blind cross-over design. The blood glucose level remained unchanged during placebo, it tended to increase during metoprolol, whereas it decreased during propranolol. Both metoprolol and propranolol counteracted the exercise-induced increase in plasma free fatty acids and caused a slight decrease in muscle glycogenolysis. The increase in blood lactate concentration during exercise was not influenced by beta-blockade. The secretion of glucagon and cortisol was not modified significantly by beta-blockade, whereas the growth hormone response to exercise was promoted equally by both beta-blocking agents. It has been assumed previously that, during treatment with beta-blocking agents, diminished hepatic gluconeogenesis, caused by the lack of lactate or free fatty acids, may result in a decline in blood glucose levels. The present results indicate that an inhibition of beta 2-mediated hepatic glycogenolysis by propranolol may also influence blood glucose homeostasis during exercise.
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PMID:Metabolic and hormonal response to physical exercise during beta 1-selective and non-selective beta-blockade. 613 38

The effect of adrenergic agonists and antagonists on the secretion of gastric somatostatin-like immunoreactivity (SLI) and gastrin was investigated in an isolated, vascularly perfused rat stomach preparation. Two- to six-fold increases in SLI secretion induced by isoproterenol, epinephrine, and norepinephrine were completely abolished by propranolol but were not influenced by phentolamine. Propranolol did not alter glucagon- and DB-cAMP-induced stimulation of SLI release. Experiments in which the beta 2-agonist salbutamol and the beta 1- and beta 2-blockers practolol and H35/25 were used showed that both subtypes of beta receptors are involved. Gastrin secretion revealed only minor changes in dose-response studies with a wide range of isoproterenol concentrations (2 X 10(-8) to 1.5 X 10(-4) M). The results obtained in this study suggest that in rats 1) the SLI response to adrenergic agonism is predominantly mediated by beta receptors; 2) both beta 1- and beta 2-adrenergic receptors are involved; 3) under in vitro conditions, adrenergic agonism is a weak stimulus for gastrin secretion.
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PMID:Adrenergic control of rat gastric somatostatin and gastrin release. 614 72

Both betaxolol and propranolol, beta blockers with different pharmacological properties, increase the reliability of somatotropic testing with glucagon. The combination of glucagon and betaxolol, however, is much better tolerated than that of glucagon and propranolol. The use of a beta 1 cardioselective adrenoceptor block for growth hormone testing is recommended.
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PMID:Betaxolol and propranolol in glucagon stimulation of growth hormone. 614 21

Effects of the new cardiotonic and selective beta 1-adrenergic agonist TA-064, (-)-(R)-1-(p-hydroxyphenyl)-2-[(3,4-dimethoxyphenethyl)amino] ethanol, on circulating concentrations of glucose, lactate, free fatty acids (FFA), glycerol, cyclic AMP and the pancreatic hormones insulin (IRI) and glucagon (IRG) were examined in rats. TA-064, administered orally or intraperitoneally at the dose of 10 mg/kg (ca. 50 times the therapeutic dose) or higher, caused a slight transient rise followed by a persistent lowering of blood glucose concentrations, but it did not affect blood lactate levels at all. The same treatment with TA-064 elevated the concentrations of blood FFA, glycerol and plasma IRI and IRG. These changes induced by TA-064 were inhibited by pretreatment with propranolol (a non-selective beta-adrenergic antagonist) and practolol (a selective beta 1-adrenergic antagonist). The non-selective beta-adrenergic agonist isoproterenol and the selective beta 2-adrenergic agonist terbutaline elevated both blood glucose and lactate when administered intraperitoneally. They also brought about sustained rises in blood glycerol and plasma IRI, but only transiently increased the plasma IRG level. The cardiotonic agent prenalterol, claimed to be a selective beta 1-agonist, elevated blood glucose, lactate, and glycerol only slightly, and plasma IRI significantly, but it had no effect on plasma IRG. The cardiotonic agents dobutamine and amrinone also elevated blood glucose. Thus, TA-064 is unique among the beta-adrenergic and other cardiotonic agents in that it produces sustained hypoglycemia while it has no lactacidemic effect. Since this hypoglycemic action of TA-064 was always preceded by a rise in plasma IRI and abolished in streptozotocin-diabetic rats, we conclude that increased secretion of pancreatic insulin and the lack of hyperglycemic action are responsible for the hypoglycemia by high doses of TA-064.
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PMID:Effects of (-)-(R)-1-(p-hydroxyphenyl)-2-[3,4-dimethoxyphenethyl)amino]ethanol (TA-064), a new cardiotonic agent, on circulating parameters of carbohydrate and lipid metabolism in the rat. 614 39

In order to assess the adrenergic contribution to hypoglycemic glucose counterregulation in type I diabetes mellitus and to determine whether the adrenergic contribution is mediated through beta 1- or beta 2-adrenergic receptors, hypoglycemia was induced by an i.v. insulin infusion (30 mU/m2 x min) for 60 min in 11 insulin-dependent diabetic patients (IDDM), 5 with normal plasma glucagon responses and 6 with blunted responses, and also in 7 age-weight-matched nondiabetic subjects. Rates of plasma glucose decrease and postnadir increase, as well as plasma concentrations of free insulin and of counterregulatory hormones, were measured when insulin was infused alone, and when insulin was infused along with propranolol (a beta 1- and beta 2-adrenergic receptor antagonist) or metoprolol (a selective beta 1-antagonist). Postnadir plasma glucose recovery was decreased in IDDM with blunted plasma glucagon responses (21 +/- 0.8 mumol x L-1 x min-1, P less than 0.001), but was normal in patients with normal plasma glucagon responses (30 +/- 0.4 versus 33 +/- 0.5 mumol x L-1 x min-1 in nondiabetic subjects, P = NS). Postnadir plasma glucose recovery was not affected by either propranolol or metoprolol in normal subjects and in IDDM with normal glucagon responses. However, in IDDM with blunted plasma glucagon responses, postnadir plasma glucose recovery was further decreased by propranolol (14 +/- 0.6 mumol x L-1 x min-1, P less than 0.01), but was unaffected by metoprolol (22 +/- 0.9 mumol x L-1 x min-1, P = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The adrenergic contribution to glucose counterregulation in type I diabetes mellitus. Dependency on A-cell function and mediation through beta 2-adrenergic receptors. 631 52

This report describes various old and new positive inotropic drugs with respect to their mechanisms of action. Drugs with established cardiotonic effects include cardiac glycosides, beta 1-adrenergic agents, glucagon, histamine and the methylxanthines. New agents discussed are prenalterol, beta 2- and alpha-adrenergic drugs, amrinone and sulmazole. Prenalterol is a beta 1-adrenergic agent. Beta 2-adrenergic drugs, amrinone and sulmazole, combine a positive inotropic and a vasodilator effect. The latter resemble theophylline and other methylxanthines in that they appear to act mainly as phosphodiesterase inhibitors with a subsequent increase in cyclic adenosine monophosphate (cAMP). The mechanism of the positive inotropic effect of alpha-adrenergic stimulating agents (for example, phenylephrine) is unknown. It is independent of the cAMP system and is not accompanied by changes in frequency.
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PMID:Inotropic drugs and their mechanisms of action. 633 Jan 95

Two beta-blocking agents, non-selective propranolol and beta 1-selective metoprolol, were investigated with respect to their effect on glucose metabolism in 11 hypertensive, non-diabetic patients. They were randomly treated for two weeks in a double-blind cross-over manner with propranolol, metoprolol and placebo. Both drugs caused a small but significant increase in basal blood glucose values as compared with placebo (p less than 0.01). Metoprolol increased the blood glucose concentrations during the first 10 min of an i.v. glucose tolerance test (IVGTT) as compared with placebo (p less than 0.02) and propranolol (p less than 0.05). Propranolol raised only the blood glucose values during the later part of the IVGTT (p less than 0.01). The increase in blood glucose concentrations was, however, not associated with significant changes in peripheral insulin levels. The mean basal glucagon concentrations were lower during propranolol and metoprolol than during placebo (p less than 0.01). Propranolol also induced a more pronounced reduction of plasma glucagon than placebo (p less than 0.05) at 10 min of the IVGTT. The mean basal free fatty acid (FFA) concentrations were lower during propranolol (p less than 0.001) and metoprolol (p less than 0.05) than during placebo. Both drugs decreased the plasma levels of FFA during the first 10 min of the IVGTT as compared with placebo (p less than 0.01 and p less than 0.02, respectively). Pharmacological doses of propranolol and metoprolol increased blood glucose concentrations, decreased plasma glucagon and FFA concentrations, but had no effect on serum insulin levels in hypertensive, non-diabetic subjects.
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PMID:Influence of beta-blocking drugs on glucose metabolism in hypertensive, non-diabetic patients. 633 83

To the extent that they have deficient glucagon secretory responses to plasma glucose decrements, as they commonly do, patients with insulin-dependent diabetes mellitus (IDDM) are dependent on epinephrine-mediated beta-adrenergic mechanisms to promote recovery from hypoglycemia. Thus, they are at increased risk for prolonged hypoglycemia if treated with a nonselective beta-adrenergic antagonist such as propranolol. If the hyperglycemic actions of epinephrine are mediated through beta 2-adrenergic mechanisms, therapeutic efficacy (e.g., for hypertension or ischemic heart disease) could be accomplished without increased risk of hypoglycemia by selective beta 1-adrenergic blockade in such patients. However, oral administration of the relatively selective beta 1-adrenergic antagonist metoprolol (100 mg) and of the nonselective beta-adrenergic antagonist propranolol (80 mg) both impaired recovery from insulin-induced hypoglycemia in patients with IDDM. Thus, at a dose of 100 mg, oral metoprolol is not safer than oral propranolol with respect to recovery from hypoglycemia in patients with IDDM.
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PMID:Oral propranolol and metoprolol both impair glucose recovery from insulin-induced hypoglycemia in insulin-dependent diabetes mellitus. 637 17

Historically, the sodium ion has been given prominence in relation to cardiovascular disease, perhaps to the exclusion of other ions. Recently, other ions, including chloride, potassium, magnesium and calcium have received increasing attention in relation to hypertension, cardiac arrhythmias, and metabolic derangements. Endocrine factors controlling these ions have also received increasing attention; they include classic hormonal actions as well as neurotransmission and paracrine hormonal actions. Studies indicate that control of the renin-angiotensin-aldosterone system resides in cytosolic calcium ion levels in the juxtaglomerular cell, as well as chloride ion and prostaglandins at the macula densa. Renin release is stimulated by hyperpolarisation of the juxtaglomerular cell induced by beta 1-agonists, parathyroid hormone, glucagon, magnesium and low cytosol calcium. Renin release is inhibited by high calcium, potassium and angiotensin II. Subsequent to renin release, hormonal regulation includes stimulation of converting enzyme activity by cortisol and prostaglandin (PGE2). Other hormonal control includes antidiuretic hormone producing dilution of extracellular electrolytes and augmented peripheral resistance. A recently identified natriuretic factor isolated from cardiac atria appears to be a potent diuretic with actions similar to that of frusemide (furosemide). Other electrolytes have received closer scrutiny. Chloride may play a dominant role in renal sodium reabsorption, responding to prostaglandin levels. Calcium has been recognised as a basic regulator of the secretion of such hormones as noradrenaline, renin, and aldosterone. As well, calcium ion changes are the means by which smooth muscle contraction is effected. Parathyroid hormone and vitamin D regulate the level of this ion in the body. In addition, a high dietary calcium intake appears to play a protective role against hypertension, while calcium channel blockers appear to reduce blood pressure. Endocrine systems play a major role in the protection against acute elevations in serum potassium by means of insulin action and adrenergic modulation of extrarenal potassium disposal. Aldosterone is recognised as the delayed regulator of potassium excretion. Magnesium levels fall in hyperaldosteronism, hyperparathyroidism, and diabetic keto-acidosis, as well as in malnutrition states. A coexisting potassium deficiency may be refractory to therapy until hypomagnesaemia is corrected. The integrated action of these hormones and electrolytes are thus of major importance in regulation of the cardiovascular system.
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PMID:Endocrine physiology of electrolyte metabolism. 638 78


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