Adverse effects

Question 1

CV effects

Answer 1

CHF in susceptible pts (pts relying on SN to maintain CO)

Bradycardia, bradyarrhythmias in pts w/ partial/complete AV conduction defects
**Esp. w/ drugs impairing sinus-node function or AV conduction, like verapamil

Cold extremeties and symptoms of PVD may worsen

Question 2

Black box warning

Answer 2

ABRUPT DISCONTINUATION AFTER LONG-TERM TREATMENT CAN EXACERBATE ANGINA AND INCREASE RISK OF SUDDEN DEATH

must decrease dose gradually and restrict exercise

Question 3

Off Target Pulmonary Effects

Answer 3

Blockade of bronchial smooth muscle B2 receptors (which promote bronchodilation)

Life-threatening increase in airway resistance

B1 selective drugs/drugs w/ ISA less likely to induce bronchospasm

selectivity of current blockers is not absolute

Question 4

Off target CNS effects

Answer 4

not as common w/ hydrophilic beta-blockers

CNS depression can occur
mental disorders, fatigue, dreams

Question 5

Off target Glucose effects

Answer 5

Hypoglycemia

• -b2 adrenoceptors stimulate glycogenolysis and gluconeogenesis and glucagon release
• -b-blockers may mask tachycardia which is warning sign for insulin induced hypoglycemia in diabetics

Question 6

Off target lipid profile effects

Answer 6

a1, b1, b2, b3 receptors mediate lipolysis

BBs cause…

• -little effect on total cholesterol and LDL
• -increase TGs and decrease HDL

ISA drugs or cardio-selectivity…less effect on TGs and HDL

with both ISA and cardio-selectivity…reduced total cholesterol and LDLs

Question 7

BB toxicity

Answer 7

in children accessing adult meds

Symptoms:

• -bradycardia
• -hypotension
• -arrhythmias
• -hypothermia
• -hypoglycemia
• -seizures