Beta Blocker RAT material

MOA:

• block NE at beta-AR

Physiology:

• bradycardia

• dec. contractility

ADRs:

• hypotension

• bradycardia

• fatigue

• sexual dysfunction

• lipid/glucose disturbances

Dosing for Metoprolol:

• 25-200 mg daily

Dosing of Carvedilol:

• 12.5-50 mg BID

Compelling indications:

• HF

• MI

• CAD

• Arrhythmias

Common Beta Blockers:

• atenolol

• metoprolol

• carvedilol

• nebivolol

• propranolol

• bisoprolol

What does Beta 1 receptor stimulation cause?

• inc. in BP and HR conduction

What does Beta 2 receptor stimulation cause?

• bronchodilates

Potency of metoprolol (beta1) :

• 5-10 mmHg

Monitoring for metoprolol:

• 2-4 weeks BP

• 2-4 weeks HR

~M

Notes for metoprolol:

• selective for Beta 1

• Metoprolol tartrate = immediate release (2-3 doses a day)

• metoprolol succinate = extended release (1 dose a day)

• on cheap list

Potency of Carvedilol (nonselective):

• 5-15 mmHg

Monitoring for carvedilol:

• 2-4 weeks BP

• 2-4 weeks HR

~ C

Notes for Carvedilol:

• nonselective for beta 1 and 2

• also alpha-blocking properties = vasodilation

• doesn’t contribute to glucose ADR