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| __NOTOC__
| | #REDIRECT [[Nadolol]] |
| {{drugbox
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| | IUPAC_name = (2''R'',3''S'')5-[2-hydroxy-3-(tert-butylamino)-propoxy]<br>tetralin-2,3-diol
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| | image = Nadolol_svg.png
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| | CAS_number = 42200-33-9
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| | ATC_prefix = C07
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| | ATC_suffix = AA12
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| | PubChem = 39147
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| | DrugBank = APRD00301
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| | C = 17 |H = 27 |N = 1 |O = 4
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| | molecular_weight = 309.401 g/mol
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| | bioavailability =
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| | protein_bound = 30%
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| | metabolism = Nil
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| | elimination_half-life = 14-24 hours
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| | excretion = [[Kidney|Renal]] and fecal (unchanged)
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| | pregnancy_AU =
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| | pregnancy_US = C
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| | pregnancy_category =
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| | legal_AU =
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| | legal_UK = POM
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| | legal_US = Rx-only
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| | legal_status =
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| | routes_of_administration = Oral
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| }}
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| {{SI}}
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| {{CMG}}
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| ==Overview==
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| '''Nadolol''' ('''Corgard''') is a non-selective [[beta-blocker]] used in the treatment of [[hypertension|high blood pressure]], [[Migraine|migraine headaches]], and [[angina pectoris|chest pain]].
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| == Chemistry and pharmacokinetics ==
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| Nadolol is nonpolar and hydrophobic, with low [[lipid]] solubility.
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| == Mechanism of action ==
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| Nadol is a beta-specific sympatholytic which non-selectively blocks beta-1 [[adrenergic receptor]]s which are mainly located in the [[heart]], inhibiting the effects of the [[catecholamine]]s [[epinephrine]] and [[norepinephrine]] and decreasing [[heart rate]] and [[blood pressure]]. It also blocks beta-2 adrenergic receptors which are located in [[bronchial]] [[smooth muscle]], causing [[vasoconstriction]]. By binding beta-2 receptors in the [[juxtaglomerular apparatus]], nadolol inhibits the production of [[renin]], thereby inhibiting [[angiotensin II]] and [[aldosterone]] production. Nadolol therefore inhibits the [[vasoconstriction]] and water retention due to angiotensin II and aldosterone, respectively.
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| The drug impairs [[atrioventricular node|AV node]] conduction and decreases [[sinoatrial node|sinus]] rate.
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| Nadolol may also increase [[blood plasma|plasma]] [[triglyceride]]s and decrease [[High density lipoprotein|HDL]]-[[cholesterol]] levels.
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| == Indications ==
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| Nadolol is indicated for treatment of moderate [[hypertension]] and [[angina pectoris|chest pain]]. In patients with severe [[hypertension]], nadolol can also treat [[tachycardia|reflex tachycardia]] due to treatment with vasodilators.
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| == Off-Label Uses==
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| A recent study found that, in certain adults with ADHD that had not responded to traditional therapies, or were unable to tolerate them, the addition of nadolol saw increase in attention and focusing capacities, along with a decrease in anxiety, impulsiveness, and somatic discomfort. [[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1940895&dopt=Abstract]]
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| == Contraindications ==
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| Patients whose heart rate is largely mediated by the [[sympathetic nervous system]] (e.g. patients with [[congestive heart failure]] or [[myocardial infarction|myocardial infarct]]) should avoid nadolol as it inhibits sympathetic function. Nadolol is also contraindicated in patients with [[bradycardia]] (slow heart rate) because of its vasodilatory effects and tendency to cause bradycardia.
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| Because of its beta-2 activity, nadolol causes pulmonary vasoconstriction and should be avoided in [[asthma]] patients in preference of a [[beta blocker|beta-1 blocker]].
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| As nadolol, like other beta-2 blockers, inhibits the release of [[insulin]] in response to [[hypoglycemia]], it slows patients' recovery from acute hypoglycemic episodes and should be avoided in some patients with [[diabetes mellitus]]. In patients with [[insulin]]-dependent diabetes, a selective beta-1 blocker is preferred over non-selective blockers.
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| == Side effects ==
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| * [[Bradycardia]]
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| * [[Fatigue (physical)|Fatigue]]
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| * [[Bronchospasm]]s
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| ==See also==
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| * [[Renin-angiotensin system]]
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| * [[Anti-hypertensive]]
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| * [[Cardiology]]
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| == External links ==
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| * [http://lysine.pharm.utah.edu/netpharm/netpharm_00/druglist/nadolol.htm Nadolol], from the University of Utah School of Medicine
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| ==References==
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| {{note|bioavailability}} {{cite journal | author= Buice RG, Subramanian VS, Duchin KL, Uko-Nne S. | title=Bioequivalence of a highly variable drug: an experience with nadolol. | journal=Pharmaceutical Research | volume=13 | issue=7 | year=1996 | pages=1109-15 }}
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| {{note|ADHD}}
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| {{beta blockers}}
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| [[Category:Beta blockers]]
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| [[Category:Drugs]]
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| [[pt:Nadolol]]
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