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Beta Blocker question

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Studying cardiology, and I am sort of stuck on a Beta blocker question. Beta blockers that exhibit ISA (beta agonist and beta antagonist activity) such as Acebutalol and Pindolol would seem... according to the literature... safe in asthma or COPD patients. Can someone explain the yes or no to this question? Thank you

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Full disclosure, I'm still learning too but- my understanding is that yes, you are correct- they are safer than other choices. First gen BBs (Propranolol, Sotalol, Timolol, and Nadolol) are non selective between b1 and b2 receptors and (due to the activity at b2) can cause bronchospasm in predisposed individuals.  Second gen BBs are cardiospecific and in low doses don't have much activity at b2 receptors. Third gen BBs (including your examples) have bronchodilatory properties. The dilation mechanism for acebutalol or pindolol stems from their ability to both excite and block the b2 receptors (ISA). Thus, they have the ability to mimic the actions of epi and norepi as b2 receptor simulators causing some bronchodilation. Should be noted that these meds can induce less bradycardia than others (in part due to their ISA) 

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18 hours ago, GetMeOuttaThisMess said:

Cardio selective Beta blockers:
Acebutolol (Sectral)
Atenolol (Tenormin)
Betaxolol (Kerlone)
Bisoprolol (Zebeta)
Esmolol (Brevibloc)
Metoprolol (Toprol, Lopressor)
Nebivolol (Bystolic)

Thank you for taking time to reply, but that wasn't the question. I was searching for information on Intrinsic Sympathomimetic Activity of Pindolol and Acebutalol. Meaning, they both block and stimulate Beta receptors. The question essentially is, do they cause enough stimulation of B2 in the lungs, while effective blocking of B1 in the heart to be safe in patients with COPD and Asthma. B1 (cardio selective) blockers are obviously the safe choice aside from these two ISA B-blockers. Thank you again!  

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