Beta-blocker Flashcards
MOA cardioselectie (B1)
B-blocker
Cardioselective (B1)
-a beta-adrenergic blocker with selective activity on beta-1 receptors located mainly in cardiac muscles. At higher doses, they also inhibit beta-2 receptors of bronchial & vascular smooth muscles.
-Possible mechanisms of antihypertensive effects: competitive decreased cardiac output, reduced sympathetic outflow, and suppression of renin activity
Drug names
Cardioslective (B1)
- Atenolol
- Bisoprolol
- Metoprolol tartrate
- Metoprolol succinate (XL)
Adverse effect
- Bradycardia
- Heart block
- Heart failure
- Hypotension/syncope
- Dyspnea, bronchospasm
- Sexual dysfunction
- Fatigue, dizziness, lethargy, depression
- Exercise intolerance
Inidcation
• Heart failure (carvedilol, bisoprolol, metoprolol XL) • Heart failure post MI (carvedilol) • Post-MI (propranolol, B1-antagonists
monitoring
• Heart rate: caution with HR <60
comments
- Abrupt d/c may cause rebound HTN
- May mask signs/symptoms of hypoglycemia in DM pts
- Selectivity of B1 agents is diminished at higher doses
nonselective
beta-blocker
MOA
competitively blocks response to beta1- and beta2-adrenergic stimulation decreases in heart rate, myocardial contractility, blood pressure, and myocardial oxygen demand.
-reduce portal pressure by producing splanchnic vasoconstriction (beta2 effect) thereby reducing portal blood flow
drugs names non selective
- Nadolol
- Nebivolol (NO activity)
- Propranolol
- Propranolol XL
- Timolol
mixed a- and b- blocker
MOA
Mixed a- and B-blocker
(vasodilation)
reduction of cardiac output, exercise- or beta-agonist-induced tachycardia, reduction of reflex orthostatic tachycardia, vasodilation, decreased peripheral vascular resistance (especially in standing position), decreased renal vascular resistance, reduced plasma renin activity, and increased levels of atrial natriuretic peptide.
mixed a- and b- blocker
drug names
- Carvedilol
- Carvedilol CR
- Labetalol
