beta blockers - stress

Question 1

what reaction do beta blockers have ?

Answer 1

BB have an antagonist action meaning they reduce sympathetic nervous system activity by reducing the activity of adrenaline and noradrenaline

Question 2

how do beta blockers work?

Answer 2

the cells in the heart have tiny strictures called beta-adrenergic receptors, when nerve endings realise noradrenaline or adrenaline into the blood stream these receptors are stimulated causing heart rate to increase - BB work by blocking these receptor cells in the heart and other organs making them less likely to be stimulated this then reduces fight or flight reactions meaning breathing and heart rate do not increase

Question 3

2 types of beta blockers?

Answer 3

1. non-selective
2. selective

Question 4

selective beta blockers?

Answer 4

• atenolol
  mostly effects the heart and reduce cardiac output and therefore they have less effect on other parts of the body

Question 4

non - selective beta blockers?

Answer 4

• propranolol
  blocks adrenaline and noradrenaline in other areas of the body as well as the heart

Question 6

research support for beta blockers ?

Answer 6

lockwood studied over 2000 musicians in the US symphony orchestra and found 27% used beta blockers and 19% used it on a daily basis they reported that it helped with stage fright and allowed them to perform under pressure

Question 7

3 effectiveness points?

Answer 7

1. don’t address emotional side of stress
2. reduces performance anxiety
3. effective in reducing blood pressure associated with stress

Question 8

BB don’t address emotional side of stress?

Answer 8

• some people suffer from stress because they’ve developed irrational thinking patterns and others because they have type A beta blockers won’t help these issues
• beta blockers may only be effective on some acute stress situations such as performance anxiety will not help emotional problems leading to chronic stress such as financial or relationship problems
• beta blockers may be effective short term it may be better to use SIT methods to tackle to source of the stress situations

Question 9

beta blockers reduce performance anxiety ?

Answer 9

• neftel et al found that string players given a selective beta blocker atenolol 6.5 hours before performing had a lower BP and were able to play more complex music accurately and reported less stage fright
• schweizer et al found students taking a maths test not all beta blockers would be effective in masking the feelings of stress. they compared different beta blockers and found they were effective in reducing BP but the anxieties before the test were still present

Question 10

beta blockers have been found effective in reducing blood pressure?

Answer 10

a meta analysis (longitudinal study) by lau et al found beta blockers reduced the risk of death by 20% in patients suffering from high blood pressure and heart disease. showing its effective calming effect on the heart
- however it may not be the case with every scenario as other factors other than stress may cause high blood pressure and heart issues for example an unhealthy lifestyle and genetic predispositions
- beta blockers lowers blood pressure but doesn’t neccesserality means it stops the anxiety that comes with stress

Question 11

2 ethical issues ?

Answer 11

1. side effects
2. enhances performance

Question 12

side effects ?

Answer 12

most side effects tend to be mild and temporary compared to other drugs
- many patients may suffer from dizziness, diarrohoea, nausea, cold hands and feet.
- however stopping taking them could suddenly cause problems such as heart palpitations and a rise in blood pressure, patients Amy also become psychologically dependent on them
- therefore it is important that patients understand the possible side effects and should only be taken if necessary

Question 13

enhances performance ?

Answer 13

• may cause ethical issues for example they have been banned for use in most sports such as olympic committee as they feel it may give an unfair advantage
• may argue that BB don’t enhance performance like steroids they simply stop the anxiety that may affect performance which would be ethically acceptable
• this has implications for those in sports however this issue should not be a problem for other professionals such as musicians

Question 14

2 social implications?

Answer 14

1. BB are prescribed off label
2. BB are being over prescribed

Question 15

beta blockers are prescribed off label ?

Answer 15

• lin et al found 52% of BB were actually off label
• the drugs will not have undergone clinical trails for the treatment of anxiety and therefore is limited research into long term effects
• the implications of this is that doctors and drug companies may face potential law suits should adverse effects emerge. theres also a problem with valid consent is health professionals do not explain that the drugs are off label and hasn’t been tested for anxiety

Question 16

beta blockers are being over prescribed ?

Answer 16

• the prescribing and primary care, health and social care information reports that prescriptions for BB propranolol rose by 7% in 2013 this could be due to increased heart problems however most believe its due to stress related illnesses.
• a bigger issue is more people needing treatment for it BB are being prescribed more than psychological therapies as its cheaper however its not effective long term