Beta-Blockers

Question 1

atenolol

Tenormin

Answer 1

Purpose: treatment of mild to moderate HTN and MI, prophylaxis of angina
Side Effects: bradycardia, cold extremities, postural hypotension, bronchospasm in overdose, 2nd or 3rd-degree heart block, insomnia, fatigue, dizziness, mental changes, n/d, hypoglycemia, impotence, thrombocytopenia
Nursing considerations:
- Mask signs of hypoglycemia in diabetics
- Check pulse; if less than 50 bpm, hold the med and contact provider
- PO: take before meals, at bedtime
- Do not stop abruptly; taper over 2 weeks
- Limit alcohol, smoking, sodium intake

Question 2

carvedilol

Coreg

Answer 2

Purpose: treatment of HTN CHF, LV dysfunction after MI, and cardiomyopathy
Side Effects: dizziness, fatigues, diarrhea, postural hypotension, impotence, hyperglycemia, CHF worsening, paresthesia, bradycardia, peripheral edema, HA, insomnia, increased liver enzymes, thrombocytopenia, bronchospams
Nurisng considerations:
- PO: take with food
- Tablet may be crushed or swallowed whole
- Do not stop abruptly; taper over 1-2 weeks

Question 3

metoprolol

Toprol- sustained-release, Lopressor - immediate release

Answer 3

Purpose: treatment of HTN, acute MI, angina, HF and cardiomyopathy
Side Effects: bradycardia, palpitations, n/v/d, hpotension/dizziness, CHF, dpression, insomnia, confusion, HA, impotence, bronchospasm, rash/urticaria, hypoglycemia
Nursing considerations:
- check pulse, if less than 60 bpm, hold med and contact provider
- PO: may be taken with food, take at same time each day
- XL tablet must be swallowed whole
- Do not stop abrutplly; taper over 2 weeks; may precipitate angina
- Do not use OTC products (nasal decongestants, cold preparations) unless directed by provider
- May worsen HF

Question 4

propranolol

Inderal

Answer 4

Purpose: treatment of stabel angina, HTN, supraventricular dysrhythmias, and acute MI; prophylaxis of migraine
Side effects: weakness, fatigue, hypotension/dizziness, impotence, bronchospams, bradycardia, n/v, depression, blurred vision, hyper/hypoglycemia, dysrhythias, thrombocytopenia, arthralgia
Nursing considerations:
- check puls; if less than 50 bpm, hold the med and contact provider
- PO: take with full glass of water at the smae time each day
- Do not stop abrutplly; taper over 2 weeks; may precipitate life-threatening dysrhythmias
- Do not use aluminum-containing antacid; may decrease absorption