beta blockers

Question 1

examples beta blockers

Answer 1

bisoprolol, atenolol, propranolol, metoprolol

Question 2

which beta blockers are b1 selective? ie cardioselective

Answer 2

BATMAN

Bisoprolol
ATenolol
Metoprolol
Acebutalol
Nebivolol

Question 3

indications beta blockers

Answer 3

HTN
ischaemic heart disease
Heart failure
Atrial fibrillation
Supraventricular tachycardia

Question 4

explain b1 and b2 receptors

Answer 4

B1 receptors are mainly on the heart, whereas B2 receptors are found mainly in the smooth muscle of blood vessels and airways.

Question 5

how do beta blockers help ishcamic heart disease

Answer 5

Beta blockers reduce the force of contraction and speed of conduction in the heart - this relieves cardiac ischaemia by reducing cardiac work and oxygen demand and increasing myocardial perfusion.

Question 6

how do beta blockers help heart failure

Answer 6

Beta blockers improve the prognosis in heart failure by protecting the heart from the effects of chronic sympathetic stimulation

beta blockers however can worsen ACUTE HF

Question 7

how do beta blockers help arrythmias

Answer 7

Beta blockers slow ventricular rate in atrial fibrillation by prolonging the refractory period in the AV node.

Beta blockers may break the reentry circuit in SVT and restore sinus rhythm

Question 8

how do beta blockers help in HTN

Answer 8

In HTN, b blockers lower blood pressure through a variety of means, one is reducing renin secretion from the kidney since this is mediated by B1 receptors

Question 9

adverse effects of beta blockers

Answer 9

may cause impotence, fatigue, headache, cold extremities, dizziness

Question 10

Contraindications beta blcokers? warnings?

Answer 10

In patients with asthma, beta blockers can cause life threatening bronchospasm and should be avoided. Beta blockers are usually safe in COPD but you should use a b1 selective eg bisoprolol, atenolol, metoprolol instead of non-selective eg propranolol

Question 11

interactions beta blockers

Answer 11

DO NOT use with non-dihydropyridine calcium channel blockers eg verapamil or diltiazem - this combination can cause heart failure, bradycardia and even asystole

Question 12

dose bisoprolol heart failure

Answer 12

Initially 1.25mg od for 1 week, then increase if tolerated to 2.5 mg once daily for 1 week, then increased if tolerated to 3.75 mg once daily for 1 week, then increased if tolerated to 5 mg once daily for 4 weeks, then increased if tolerated to 7.5 mg once daily for 4 weeks, then increased if tolerated to 10 mg once daily.

Question 13

dose atenolol arrythmiaas

Answer 13

By mouth
Adult
50–100 mg daily.

Question 14

dose bisoprolol angina

Answer 14

5mg od. Usual maintenance 10mg od