The Role of Non-Selective Beta-Blockers (NSBBs) in Liver Cirrhosis

Anak Agung Yunda Prabundari; I Dewa Nyoman Wibawa

doi:10.3889/oamjms.2023.10109

Authors

Anak Agung Yunda Prabundari Department of Internal Medicine, H. Marsidi Judono District Hospital, Belitung, Indonesia
I Dewa Nyoman Wibawa Internal Medicine Department, Gastro-Entero-Hepatology Division, Udayana University, Sanglah Hospital, Denpasar, Bali, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2023.10109

Keywords:

beta blockers, NSBB, liver cirrhosis, propranolol, carvedilol

Abstract

Non-selective beta-blockers (NSBBs) are one of the recommended treatments for portal hypertension in liver cirrhosis (LC). NSBB plays the role of primary as well as secondary prophylactic upper gastrointestinal bleeding in LC. NSBB therapy has been shown to effectively reduce the risk of variceal bleeding, reduction of portal pressure, and treat other complications of portal hypertension. The safety of NSBB therapy in cirrhosis requires a good therapeutic guide and considers the side effects. The indication of NSBB administration is adjusted according to the cirrhosis stage and the specific pathophysiology that occurs in cirrhosis. Conventional NSBBs such as propranolol and nadolol which are antagonists of β1 and β2 adrenergic receptors would induce decreased cardiac output and splanchnic vasoconstriction. Carvedilol is an NSBB with the addition of α1-adrenergic activity in reducing portal pressure stronger than conventional NSBB, so carvedilol can cause greater systemic arterial pressure reduction when compared to conventional NSBB. The appropriate treatment strategies can be applied in the use of NSBB to prevent more severe complications and reduce morbidity and mortality.

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Author Biography

I Dewa Nyoman Wibawa, Internal Medicine Department, Gastro-Entero-Hepatology Division, Udayana University, Sanglah Hospital, Denpasar, Bali, Indonesia

Internal Medicine Department, Gastro-Entero-Hepatology Division, Udayana University, Sanglah Hospital, Denpasar, Bali, Indonesia

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