22: Beta Blockers Flashcards
What is the relationship between beta blockers and RAAS?
- B1 and B2 receptors in the kidney mediate renin release
- Beta blockers prevent renin release and activation of RAAS
What causes the main long term benefits of beta blockers?
Changing activity of kinases associated with beta blockers
Elimination and half life are dependent on ____
Solubility (water vs lipid)
What is the most commonly used beta blocker?
Metoprolol
Which beta blocker is used for hypertensive emergencies?
- Esmolol
- B1 selective
- IV infusion
- broken down by esterases in the blood
Which beta blocker is used for AF treatment?
Sotalol
What are the 3 main effects of beta blockers on the CVS?
- Blood pressure lower
- Negative chronotropic
- Inotropic effects (depending on clinical stage)
When are beta blockers contraindicated?
Asthmatics
Acute CCF
With verapamil
What advice do you need to give to patients with diabetes on beta blockers?
- Can mask symptoms of hypoglycaemia (due to suppressed sympathetic drive)
What are some adverse effects of BBs?
Respiratory - asthma exacerbation
CVS - hypotension, bradycardia, acute CCF exacerbation, vasospasm
Other - fatigue, impotence, nightmares, hypoglycaemia mask, drug withdrawal
Which beta blocker is used for hypertension during pregnancy?
Labetalol
What is the use of beta blockers post MI?
- Prevent adverse modelling and arrhythmias by preventing big sympathetic surge post MI
What is the use of beta blockers in chronic heart failure?
- Decreases sympathetic tone
- Up-regulation of beta receptors
- Improve baroreceptor function
- Improve LV remodelling
- Attenuate apoptosis
- Modulation of post receptor inhibitory proteins
Beta blockers are ___ line therapy in hypertension
2nd/3rd line
