Effect of Landiolol Hydrochloride on Hemodynamics in a Histamine-Induced Shock Model

Masaharu Hirano, Tatsuaki Okamura, Tetsuji Nagano, Shigeyuki Nonaka, Tsutomu Shiroya

Research output: Contribution to journalArticlepeer-review


Background and Objective: Anaphylactic shock is a serious adverse drug reaction that can occur in response to contrast media used during coronary computed tomography angiography. The imaging quality of coronary computed tomography angiography is improved by β-blockers, which decrease heart rate. In this study, we sought to analyze anaphylactic shock treatment in patients receiving short-acting β1-blockers. Methods: We examined the influence of epinephrine and glucagon on hemodynamics during β-blocker treatment, using a dog histamine shock model; the β1-blocker landiolol hydrochloride was used. The effects of these drugs were assessed by recording changes relative to established baselines. Results: Histamine and landiolol decreased mean blood pressure. Histamine exerted no apparent effect on heart rate, whereas landiolol decreased heart rate. Further, landiolol reduced histamine-mediated increases in the force of cardiac contraction. Increasing the doses of epinephrine and glucagon ameliorated anaphylactic shock-induced deterioration in hemodynamic parameters in subjects receiving landiolol. Conclusions: In patients receiving landiolol for coronary computed tomography angiography, deterioration in hemodynamic parameters due to anaphylactic shock can be mitigated by increasing the doses of epinephrine and glucagon. Clinicians should thus prepare appropriate amounts of epinephrine and glucagon prior to coronary computed tomography angiography.

Original languageEnglish
Pages (from-to)321-329
Number of pages9
JournalDrugs in R and D
Issue number3
Publication statusPublished - 2021 Sept
Externally publishedYes

ASJC Scopus subject areas

  • Pharmacology


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