acebutolol
Summary
Cardioselective (beta-1) beta-blocker with intrinsic sympathomimetic activity (ISA), meaning it acts as a partial agonist. Used for hypertension and ventricular arrhythmias.
Detail
Acebutolol selectively blocks beta-1 receptors but exhibits intrinsic sympathomimetic activity, providing partial agonism that minimizes bradycardia and lipid changes compared with pure antagonists. Because of ISA, it is avoided in post-MI secondary prevention and angina, where full beta-blockade is desired. Indications include hypertension and premature ventricular contractions. Adverse effects include bronchospasm at high doses (loss of selectivity), fatigue, and lupus-like syndrome (rare). Boards mnemonic: beta-blockers with ISA = 'A BBC Pind' (Acebutolol, Bopindolol, Bucindolol, Carteolol, Pindolol); avoid in ischemic heart disease.
Sources
- First Aid for USMLE Step 1 2024
- Sketchy Pharmacology
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