ACEBUTOLOL MERCK 200 mg Acebutolol in 200 mg scored tablets Action
Beta blockers.
In General, β-blockers are used to reduce blood pressure, reduce the disorders of heart rhythm, slow the c? ur and thus make savings on its operation. For all these reasons, they are also used in coronary failure.
The beta blocker is a substance that has the ability to bind to receptors called beta-receptors or adrenoceptors (see below).
Β-blockers may have side effects on the pulmonary tree, such as bronchoconstriction (asthma). They are therefore contraindicated in asthma. There is an interaction between β-blockers, the sympathetic system and thus the regulation of blood sugar (which is disrupted, leading to a hypoglycaemia). This molecule tends to become more cardiosélective (exclusive action on beta, receptor predominant in the c? ur).
It also distinguishes β-blockers by their intrinsic sympathomimetic (ASI) activity or not. The presence of intrinsic sympathomimetic activity is originally of lower lower bradycardia at rest, less effects bronchoconstrictors or vasoconstrictor and least metabolic disturbance. This variety of β-blockers is ineffective for treating migraines.
Among β-blockers, Acebutolol is an inhibitor in competition with catecholamine level of Beta Adrenergic receptors and especially those of the c? ur, vessels and lungs.
Acebutolol is part of cardiosélectifs β-blockers that must theoretically be action on cardiac 1 beta receptors. On the other hand, it has slight intrinsic sympathomimetic activity likely to reduce the importance of the bradycardia.
Acebutolol has also, as the set of β-blockers, an antiarrhythmic effect, an antiangoreux and antihypertensive effect.

Indications
• Angina
• Tachyarrhythmia

The injectable form is used in emergency, under electrocardiographic monitoring, to treat different types of tachycardia and any particularly junctional tachycardia, atrial flutter, and some cases of ventricular premature beats atrial fibrillation.

Contraindications
• Pure Prinzmetal Angina
• Asthma
• High degree non-left atrioventricular block
• Significant bradycardia (heart rate less than 40 beats per minute)
• Pregnancy and breastfeeding (of β-blockers may be prescribed if necessary after medical consensus). It does not exist, apparently known teratogenic effect. Nevertheless monitor the baby the first five days: blood sugar, frequency and State respiratory and heart rate
• Orthostatic hypotension
• Uncompensated heart failure
• Sick sinus including sinoatrial block
• Untreated pheochromocytoma
• Syndrome of Raynaud and peripheral arterial disorders in their severe forms

Adverse effects
• Asthenia early treatment
• Asthma
• Atrioventricular block
• Severe bradycardia
• Nightmares and insomnia
• Skin diseases
• Diarrhea
• Gastralgies
• Hypoglycemia
• Low blood pressure
• Orthostatic hypotension
• Heart failure
• Nausea
• Paresthesia of the extremities
• Raynaud’s syndrome
• Vomiting
Acute poisoning is responsible for a decrease in blood pressure and slow the heart rate and the electrical conduction between the atrium and ventricle.

Dosage
• Angina and tachyarrhythmia: 400-800 mg per day in three catches a day preferably.
• Myocardial infarction: 200 mg in the morning and evening to start from the third day.
• High blood pressure: 400 mg per day in one taken the morning or 200 mg morning and evening

Precautions and use
Never interrupt the treatment, especially when there are angina pectoris, because there is a risk of myocardial infarction, serious disorders of the rhythm and sudden death.
The dosage should be reduced in renal failure.
Monitoring of the treatment must search for the occurrence of signs of failure heart, especially when there is a history of this type, and especially in the elderly
In the diabetic patient: the signs announcing a hypoglycemia, such as palpitations and sweats, can be hidden. It is best to use cardiosélectif beta blockers and strengthen Glycemic controls at the beginning of the treatment.
The use of β-blockers must be done with caution when there is a first degree atrioventricular block.
Precaution also in the case of pheochromocytoma: always associate an alpha blocker to prevent hypertensive crisis.
Precautions in the presence of a chronic obstructive bronchopathie and history of bronchospasm
Patients with Raynaud’s syndrome will have to take of β-blockers only after medical consensus.
Molecule for use with caution when there is history of anaphylactic shock.
Presence of renal or hepatic failure, it is preferable to favour a beta blocker that is not eliminated by the insufficient body, or reduce the dosage.
In general anaesthesia, it is recommended to stop 48 hours before processing or predict a premedication of atropine if necessary.

Drug interactions
• Amiodarone
• Halogenated volatile anesthetics
Antacids •
• Tricyclic antidepressants
• Antidiabetic
Non-steroidal anti-inflammatory •
• Bepridil
• Cimetidine
• Corticosteroids
• Diltiazem
• Disopyramide
• Floctafénine
• Lidocaine
• Liorésat
• Mefloquine
• Neuroleptic
• Nifedipine
• Iodinated contrast
• Quinidiniques
• Sultopride
• Tacrine (risk of excessive bradycardia)
• Verapamil