Name: Nadolol (Corgard)
Class: Nonselective b-Blocking Agent
Mechanism: Competitive blockade of b1 and b2 receptors. No a effect.
Absorp.: Poor oral (>30%). Low bioavail: ~30%. Plasma levels vary 7x btwn. pts.
Dist.: 30% bound to protein.
Metabolism.: Excretion, t½: Renal. Long t½ (14-24 hr). Unchanged in urine.
Toxicity/S.E.s: CV—hypotension, bradycardia, c/i for CHF or AV block. Resp—c/i in asthmatics, COPD, bronchitis, allergic rhinitis. Metabolism—caution w/diabetics (masks signs of hypoglycemia: tachycardia). CNS—weakness, fatigue, nightmares, depression. GI—n/v (uncommon). Hypersens—rash, hematologic disorders (rare).
Utility: Hypertension (¯ CO ® ¯ BP; blocks renin release). Angina pectoris (prophylactic ® exercise tolerance due to ¯ O2 demand). Cardiac arrhythmias (esp. supravent. tachyarrhyths). Acute MI (prophylaxis and reduction of infarct size and failure). Pheochromocytoma (in comb. w/alpha blocker). Essential tremor. Migraine headache (prophylaxis). Performance anxiety.
Special Features: Abrupt w/drawal may trigger MI. Better pt. compliance than w/propranolol.