Updated: 2/11/2020

Beta-Blockers

0%
Topic
Review Topic
0
0
N/A
N/A
Questions
7 7
0
0
0%
0%
Evidence
5 5
0
0
Topic
β-Blocker Selectivity
 
Drug Effect
Clinical Applications Toxicity
Nonselective β-Antagonists (β1 = β2)


Propranolol, 
nadolol,
timolol

Lowers BP and HR
Reduces renin secretion
Decreases cardiac ouptut and increases peripheral resistance 
Hypertension
Arrhythmias
Angina pectoris
Migraines
Hyperthyroidism
Glaucoma (timolol)
Bradycardia
Fatigue 
Worsening asthma
Vivid dreams
 β1-Selective Antagonist (β1 > β2) 
Metoprolol,
atenolol,
betaxolol
Lowers BP and HR
Reduces renin secretion
Hypertension
Arrhythmias
Angina pectoris
Same toxicity as above but safer in asthma 
Esmolol Very rapid onset of action (10 min half-life)
Rapid control of supraventricular arrhythmias, BP, and thyrotoxicosis  
Bradycardia
Hypotension
Nonselective α- and β-Antagonists (β1 = β2 ≥ α1 > α2
Labetalol,
carvedilol
  Heart failure
Fatigue
Partial β-Agonists (β1 = β2 Blockade with Some β-Agonist Activity) 
Acebutolol,
pindolol, 
carteolol 
Lowers HR less than the effect on BP
Hypertension
Arrhythmias
Hypotension but less tachycardia than alpha blockers such as phentolamine
 
Mechanism of Action for Clinical Application
 
Clinical Application
Mechanism
Hypertension
  • ↓ Cardiac output 
  • ↓ Renin secretion by blocking β-receptor on JGA cells
Angina pectoris
  • ↓ O2 consumption by ↓ heart rate and contractility 
SVT (propranolol, esmolol)
  • ↓ AV conduction velocity
MI
  • ↓ Mortality
CHF
  • Slows progression
Glaucoma (timolol)
  • ↓ Secretion of aqueous humor
Topic Rating

Please rate topic.

Average 4.9 of 10 Ratings

 

Questions (7)
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK

(M1.PH.14.44) A 62-year-old male is rushed to the emergency department (ED) for what he believes is his second myocardial infarction (MI). His medical history is significant for severe chronic obstructive pulmonary disease (COPD) and a prior MI at the age of 58. After receiving aspirin, morphine, and face mask oxygen in the field, the patient arrives to the ED tachycardic (105 bpm), diaphoretic, and normotensive (126/86). A 12 lead electrocardiogram shows ST-elevation in I, aVL, and V5-V6. The attending physician suspects a lateral wall infarction. Which of following beta-blockers should be given to this patient and why? Tested Concept

QID: 100847
1

Propranolol, because it is a non-selective ß-blocker

12%

(7/57)

2

Metoprolol, because it is a selective ß1 > ß2 blocker

68%

(39/57)

3

Atenolol, because it is a selective ß2 > ß1 blocker

4%

(2/57)

4

Labetalol, because it is a selective ß1 > ß2 blocker

11%

(6/57)

5

Nadolol, because it is a selective ß1 > ß2 blocker

0%

(0/57)

M 3 D

Select Answer to see Preferred Response

Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Question locked
Sorry, this question is for
PEAK Premium Subscribers only
Upgrade to PEAK
Evidence (5)
Topic COMMENTS (11)
Private Note