Beta Blockers (week 4)

Question 1

How do beta blockers work?

Answer 1

they block the effects of epinephrine and norepinephrine on beta receptors throughout the body

Question 2

What are the four selective beta blockers?

Answer 2

atenolol, metoprolol tartrate, metoprolol succinate, nebivolol

Question 3

What are the two nonselective beta blockers?

Answer 3

carvedilol, propanolol

Question 4

FDA approved indications for beta blockers include

Answer 4

high blood pressure, chest pain, post heart attack, abnormal heart rhythm

Question 5

Beta-1 is located on the heart, and works by

Answer 5

decreasing heart rate and frequency of contractions

Question 6

Beta-2 is located

Answer 6

on blood vessels, in the GI tract and lungs

Question 7

Beta-2 works by

Answer 7

decreasing heart rate and affecting vasoconstriction

Question 8

Non-selective beta blockers antagonize which beta receptors?

Answer 8

both beta 1 and beta 2 without preference

Question 9

Selective beta blockers block which beta receptors?

Answer 9

only beta 1 receptors (it is cardioselective)

Question 10

Which beta blocker is the only beta blocker approved for essential tremor and migraine prophylaxis?

Answer 10

propanolol

Question 11

Heart failure is an indication only FDA approved for which two beta blockers?

Answer 11

carvedilol and metaprolol succinate

Question 12

What are the common adverse effects of beta blockers?

Answer 12

hypotension, bradycardia, fatigue (improves after 2-4 weeks) and decreased sexual ability

Question 13

What are the serious adverse effects of beta blockers?

Answer 13

worsening heart failure symptoms and shortness of breath

Question 14

What are the drug interactions for beta blockers?

Answer 14

antidiabetic agents and insulin (masks signs and symptoms of hypoglycemia), NON-DHP CCBs, amiodarone, clonidine and digoxin (decrease heart rate)

Question 15

What is the box warning for beta blockers?

Answer 15

risk of chest pain/myocardial infarction, decreased oxygenation of heart muscle - should be tampered off slowly

Question 16

What are the precautions for beta blockers?

Answer 16

may worsen depression and hepatic impairment (excluding atenolol)

Question 17

What are the contraindications for beta blockers?

Answer 17

sinus bradycardia, asthma or COPD

Question 18

What is the difference between metaprolol tartrate and metaprolol succinate?

Answer 18

tartrate is fast acting, so the patient would take it twice a day and take succinate once per day

Question 19

What are the patient counseling points for beta blockers?

Answer 19

to not abruptly discontinue, that they will experience fatigue that will go away after 2-4 weeks, and counseled on associated disease

Question 20

What is a clinical pearl for beta blockers?

Answer 20

co-administration of beta blockers and nondihydropyridine calcium channel blockers should BE AVOIDED

Question 21

What is the brand name for atenolol?

Answer 21

Tenormin

Question 22

What is the brand name for carvedilol?

Answer 22

Coreg

Question 23

What is the brand name for metaprolol tartrate?

Answer 23

Lopressor

Question 24

What is the brad name for metaprolol succinate?

Answer 24

Toprol XL

Question 25

What is the brand name for nebivolol?

Answer 25

Bystolic

Question 26

What is the brand name for propanolol?

Answer 26

Inderal LA and Inderal XL