Why the study?
Does dilevalol cause less bronchoconstriction than metoprolol in patients with reversible bronchial asthma?
Does dilevalol cause less bronchoconstriction than metoprolol in patients with reversible bronchial asthma?
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In patients with reversible bronchial asthma, a single high dose of dilevalol caused less bronchoconstriction than metoprolol, suggesting it may be a safer beta-blocker option in this population.
Activation of the cardiac beta-adrenergic receptor stimulates cAMP levels and activates cAMP-dependent protein kinase. The kinase phosphorylates the calcium channel and enhances thereby the availability and the number of channels that are opened during depolarization. The increased calcium influx leads then to a positive inotropic response. The calcium channel can be identified in vitro by organic calcium channel blockers, which bind stereoselectively to a high affinity, low capacity site localized in sarcolemma and junctional sarcoplasmic reticulum. This binding site has been purified from skeletal muscle microsomes. The purified receptor contains three peptides of Mr 165, 55, and 32 kDa in stoichiometric amounts. The high affinity binding sites for dihydropyridines and phenylalkylamines are localized on the 165 kDa peptide. This peptide is phosphorylated up to 2 mol/mol by cAMP-dependent protein kinase. Reconstitution of the purified receptor yields a calcium channel that has many properties of the cardiac L-type calcium channel. It is suggested that these properties are confined to a 165 kDa peptide in skeletal muscle and to a 183 kDa peptide in cardiac muscle.
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Hofmann et al. (1988) studied this question.
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