beta blockers (selective and non-selective)

Question 1

Indications of beta blockers?

Answer 1

hypertension, angina, anxiety symptoms, arrhythmia, migraine, tremor

Question 2

Contraindications of beta blockers?

Answer 2

asthma, cardiogenic shock, hypotension, second/third degree AV block, marked bradycardia, metabolic acidosis, pheochromocytoma, prinzmetals angina, severe peripheral arterial disease, sick sinus syndrome, uncontrolled heart failure

Question 3

Mechanism of action of beta blockers

Answer 3

block adrenaline (epinephrine) and noradrenaline (norepinephrine) adrenergic receptors (competitive antagonist) on beta cells in the sympathetic nervous system. adrenaline is a stress hormone which increases HR and BP by vasoconstriction so less of it makes blood cells vasodilate - it reduces BP and slows HR. non-selective beta blockers work at multiple sites within the body and selective beta blockers work on cardiac muscle only

Question 4

Common side effects of beta blockers

Answer 4

headache, nausea, vomiting, diarrhoea, hypotension, bradycardia, altered metabolism of lipids/glucose, vivid dreams/nightmares, worsening of Raynauds, cold hands and feet, tiredness, insomnia, erectile dysfunction, dizziness

Question 5

Monitoring requirements for beta blockers

Answer 5

monitor lung function

Question 6

Treatment cessation of beta blockers

Answer 6

avoid abrupt withdrawal, especially in ischaemic heart disease. sudden cessation can cause a worsening of myocardial ischaemia and gradual reduction dose should be done

Question 7

Patient and carer advice for beta blockers

Answer 7

if HR is below 60 but BP is normal, highlight to doctor