الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
New medicines are urgently needed to reduce chronic obstructive pulmonary disease (COPD) exacerbations and improve patients’ quality of life. COPD represents an important health challenge in both prevention and treatment. Nearly 90% of fatalities from COPD happen in middle-income and low-income countries. Beta-blockers, particularly cardio-selective ones, are well tolerated and linked to a lower incidence of acute exacerbations, mortality, and improved quality of life of individuals with COPD. Beta-blockers may be also beneficial in patients with COPD who are with no cardiovascular disorders since beta-blockers have potential noncardiac effects. It was discovered that nebivolol use in essential hypertension patients had a positive influence on peak respiratory flow as well as an enhanced quality of life. Nebivolol use in COPD patients with cardiovascular diseases reported good tolerability in comparison with other beta-blockers in terms of airway conductance, COPD clinical signs, interaction with the bronchodilation effect, and results of spirometry.
This study was designed to investigate the effect of nebivolol on the respiratory functions and exercise tolerance of COPD patients without cardiovascular disease as well as to assess its safety in those patients. The current study was a prospective, randomized, single-blind, placebo-controlled pilot study. It was designed as a crossover study with two 12-week periods comparing nebivolol once daily to placebo in COPD patients without overt cardiovascular disease. Pulmonary function tests (FEV1, FVC, and FEV1/FVC), COPD Assessment Test (CAT) score, modified Medical Research Council Dyspnea Scale (mMRC), dyspnea index, six minutes’ walk test (6MWT), and vital signs were assessed at baseline and at the end of the treatment.
All thirty enrolled COPD patients completed period one of this study, one patient withdrew consent at the end of period one complaining of fatigue and loss of energy. The 29 patients who completed the second period remained clinically stable throughout the study and did not complain of any side effects other than an increase in the FEVl/FVC ratio, therefore, nebivolol had no significant effect on the pulmonary functions, and the 6MWT over placebo. During the period of study, none of patients required hospitalization due to COPD exacerbation or even experienced shortness of breath.
Nebivolol was well tolerated in COPD patients and positively affected the FEVl/FVC ratio. Patient’s satisfaction with the services offered by the clinical pharmacist in the chest outpatient clinic was only moderate; older patients appeared to be more satisfied with the services than younger ones and, thus, improvement of the pharmacist role and participation in patient care and community health status should take more attention from the pharmacist side and should be taken in consideration in order to increase patient’s satisfaction