BB Flashcards

1
Q

Side effects

A
  • Fatigue
  • brady
  • bronchospasms
  • coldness of extremities
  • sleep disturbance (less common with water soluble)
  • GI
  • Mask symptoms of hypo
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2
Q

Monitoring

A
  • ECG (for bradycardia), Heart Rate (HR)
  • Blood glucose levels in diabetics
  • Lung function in patients with history of obstructive airway disease
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3
Q

Withdrawal

A

Avoid abrupt

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4
Q

CI

A
  • 2nd or 3rd degree heart block
  • Worsening UNSTABLE heart failure (but cautioned in stable heart failure)
  • History of asthma/COPD or bronchospasm (because they precipitate bronchospasm)
  • Avoid in frequent hypo
  • Peripheral vascular disease
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5
Q

Drug interactions

A
  • Verapamil (and diltiazem) and Beta-blockers (high risk of hypotension and heart failure)
  • AVOID combination
  • Theophylline/Aminophylline -
    Increases risk of bronchospasms
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6
Q

Which beta-blockers are likely to have less coldness of extremities and less bradycardia as a side-effect (have ISA)?

A

These have intrinsic sympathomimetic activity (ISA)
Celiprolol
Acebutolol
Pindolol
Oxprenolol
Accronymn: ISA-CAPO

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7
Q

Water-soluble beta-blockers

A
  • Celiprolol
  • Atenolol
  • Nadolol
  • Sotalol

CANS

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8
Q

What are the
characteristics of water soluble beta-blockers?

A
  • less likely to enter the brain, therefore less sleep disturbances and nightmares
  • Excreted by kidneys (dose reduction in renal impairment)
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9
Q

Lipid soluble beta-blockers

A
  • Propranolol
  • Bisoprolol
  • Carvedilol
  • Labetalol
  • Metoprolol
  • timolol
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10
Q

Cardioselective beta-blockers?

A

Beta-blockers that have a higher affinity for b1 receptors in the heart
They are SELECTIVE, but NOT specific - so they can still affect the airways to a lesser
extent
Examples:
- Bisoprolol
- Atenolol
- Metoprolol
- Nebivolol

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11
Q

What are the common
NON-cardioselective beta-blocker?

A

Sotalol
Propranolol

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12
Q

Which beta-blockers have an intrinsically longer duration of action?

A

Give OD
- Atenolol
- Bisoprolol
- Celiprolol
- Nadolol

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13
Q

What type of beta-blocker is Atenolol (i.e. what are their characteristics?)

A
  • Cardio-selective and water soluble
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14
Q

Is Bisoprolol water soluble?

A

No, they are lipid soluble
Bisoprolol is cardioselective but NOT water-soluble so it
can cause sleep disturbances and vivid dreams

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15
Q

Which beta-blockers can be used in asthmatics→

A

Atenolol, Bisoprolol and Celiprolol (cardioselective beta blockers)

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16
Q

Which beta-blockers are associated with nightmares and which beta-blockers are advisable to lessen these symptoms

A

Lipophilic beta-blockers (Metoprolol, Propranolol and Carvedilol). Therefore hydrophilic beta-blockers are appropriate alternatives (Atenolol and Sotalol)

17
Q
A