pindolol

Pindolol is a medication in the class of non-selective beta-adrenergic receptor antagonists (beta-blockers) with intrinsic sympathomimetic activity (ISA). It binds to beta-1 and beta-2 receptors and reduces sympathetic stimulation of the heart and vasculature. The ISA means pindolol can produce a small degree of receptor activation at rest, which dampens sudden changes in heart rate and avoids excessive bradycardia and negative inotropy seen with pure antagonists.

Common indications include hypertension, where it lowers blood pressure by reducing heart rate, myocardial contractility, and cardiac output; and it has been used for angina pectoris and certain arrhythmias. Because of its non-selectivity, pindolol can affect airways and should be used with caution in patients with bronchospastic disease.

Pharmacokinetics: pindolol is administered orally, well absorbed from the gastrointestinal tract, and undergoes hepatic metabolism with renal excretion of metabolites and some unchanged drug. The elimination half-life is typically a matter of hours, often necessitating dosing every 6 to 12 hours depending on the formulation.

Adverse effects and cautions includebradycardia, hypotension, fatigue, dizziness, and bronchospasm in susceptible individuals. It can mask signs of hypoglycemia and may worsen heart failure in decompensated states. Caution is advised when combined with other antihypertensives, calcium channel blockers, or insulin/oral hypoglycemics.

History and availability: Pindolol was developed in the 1960s and marketed under the brand name Visken. It remains a historic example of a non-selective beta-blocker with ISA, though many current guidelines favor other agents depending on patient characteristics.