Beta-blockers

beta-1 selective is also referred to as

cardio-selective

Propranolol (type)

prototype
NON-selective beta antagonist (1st gen)
competitive, reversible antagonist

Propranolol (use)

Treats hypertension, chest pain, cardiac arrhythmias, MIs, pheochromocytoma, migraine prevention, tremors

Timolol (type)

NON-selective beta antagonist (1st gen)
competitive, reversible antagonist

Timolol (use)

Treats glaucoma
-lowers intraocular pressure

Sotalol (type)

NON-selective beta antagonist (1st gen)
competitive, reversible antagonist

Sotalol (use)

Treats cardiac arrhythmias
-blocks ion channels

Nadolol (type)

NON-selective beta antagonist (1st gen)
competitive, reversible antagonist

Nadolol (use)

treats hypertension & migraine

Metoprolol (type/use)

classic beta-1 selective antagonist (2nd gen)
competitive, reversible antagonist
-reduces heart rate mortality; migraine tx

Esmolol (type)

beta-1 selective antagonist (2nd gen)
competitive, reversible antagonist
(ultra short-acting)

Esmolol (use)

Short term use, acts fast (~8min half life); IV admin
Treats tachycardia (Post- or intra-operative)

Bisprolol (type/use)

beta-1 selective antagonist (2nd gen)
competitive, reversible antagonist
-reduces heart failure mortality

Atenolol (type/use)

beta-1 selective antagonist (2nd gen)
competitive, reversible antagonist
-migraine tx

Labetolol (use)

RAPID tx for hypertension, lowers BP hypertensive emergencies

Labetolol (type)

NONSELECTIVE beta antagonist (3rd gen)
competitive, reversible inhibitor

Carvedilol (type)

NONSELECTIVE beta antagonist (3rd gen)
competitive, reversible inhibitor

Carvedilol (use)

Treatment for heart failure, hypertension, MI's
-Antioxidant, anti-inflammatory
-blocks L-type Ca2+ channels at high levels

Nebivolol (type)

beta-1 selective antagonist (3rd gen)

Nebivolol (use)

Treats hypertension
-Stimulates NO-mediated vasodilation

Pts with heart failure should use one of these beta-blockers: (3)

Bisprolol
Metoprolol
Carvedilol

Beta-blockers were originally designed to treat

angina

Pts who have had a myocardial infarction should take one of these beta-blockers: (3)

Propranolol
Timolol
Metoprolol

Beta-blocker that can treat glaucoma:

Timolol; or, any beta-blocker that does NOT have anesthetic properties

Beta-blockers that can prevent migraine:

Nadolol
Atenolol
Propranolol, Metoprolol, Timolol

Treatment for tremors and anxiety: (1)

propranolol

Beta-1 selective antagonists should be used if the pts have these comorbidities: (4)

-Asthma/COPD, bronchospasms
-Diabetes
-Peripheral vascular disease
-Raynaud's phenomenon

How do you avoid Withdrawal Syndrome?

Pt & Provider must slowly taper the dosage of beta-blocker. This prevents the pt from having a myocardial infarction.