Beta-blocker

Question 1

MOA
cardioselectie (B1)

Answer 1

B-blocker
Cardioselective (B1)
-a beta-adrenergic blocker with selective activity on beta-1 receptors located mainly in cardiac muscles. At higher doses, they also inhibit beta-2 receptors of bronchial & vascular smooth muscles.
-Possible mechanisms of antihypertensive effects: competitive decreased cardiac output, reduced sympathetic outflow, and suppression of renin activity

Question 2

Drug names

Cardioslective (B1)

Answer 2

• Atenolol
• Bisoprolol
• Metoprolol tartrate
• Metoprolol succinate (XL)

Question 3

Adverse effect

Answer 3

• Bradycardia
• Heart block
• Heart failure
• Hypotension/syncope
• Dyspnea, bronchospasm
• Sexual dysfunction
• Fatigue, dizziness, lethargy, depression
• Exercise intolerance

Question 4

Inidcation

Answer 4

•	Heart failure 
(carvedilol, bisoprolol, metoprolol XL)
•	Heart failure post MI (carvedilol)
•	Post-MI
(propranolol, B1-antagonists

Question 5

monitoring

Answer 5

• Heart rate: caution with HR <60

Question 6

comments

Answer 6

• Abrupt d/c may cause rebound HTN
• May mask signs/symptoms of hypoglycemia in DM pts
• Selectivity of B1 agents is diminished at higher doses

Question 7

nonselective
beta-blocker
MOA

Answer 7

competitively blocks response to beta1- and beta2-adrenergic stimulation  decreases in heart rate, myocardial contractility, blood pressure, and myocardial oxygen demand.
-reduce portal pressure by producing splanchnic vasoconstriction (beta2 effect) thereby reducing portal blood flow

Question 8

drugs names non selective

Answer 8

• Nadolol
• Nebivolol (NO activity)
• Propranolol
• Propranolol XL
• Timolol

Question 9

mixed a- and b- blocker

MOA

Answer 9

Mixed a- and B-blocker
(vasodilation)
reduction of cardiac output, exercise- or beta-agonist-induced tachycardia, reduction of reflex orthostatic tachycardia, vasodilation, decreased peripheral vascular resistance (especially in standing position), decreased renal vascular resistance, reduced plasma renin activity, and increased levels of atrial natriuretic peptide.

Question 10

mixed a- and b- blocker

drug names

Answer 10

• Carvedilol
• Carvedilol CR
• Labetalol