Beta blockers

Question 1

What are the generic and brand names of beta blockers?

Answer 1

• Atenolol (Tenormin)
• Bisoprolol (Cardicor)
• Nebivolol
• Propanolol

Question 2

What is the method of action of beta blockers?

Answer 2

• Beta 1 receptors are mainly on the heart
• Beta 2 receptors are mainly in smooth muscle of blood vessels
• Stops adrenaline binding to these receptors
• = sympathetic nerves are not stimulated
• Reduces force and speed of contraction of the heart
• Also reduces renin secretion = lowers blood pressure

Question 3

What are the indications for beta blockers?

Answer 3

• Ischemic heart disease – improving symptoms associated with angina and acute coronary syndrome
• Chronic heart failure
• AF
• SVT
• Hypertension – not first line

Question 4

What are the contraindications for beta blockers?

Answer 4

• Asthma – causes bronchospasms
• COPD – choose Beta 1 selective only
• Haemodynamic instability
• Heart block
• Hepatic failure – dosage reduction

Question 5

What are the side effects of beta blockers?

Answer 5

• Fatigue
• Cold extremities
• Headache
• GI upset
• Sleep disturbances/nightmares
• Impotence

Question 6

What are the interactions with beta blockers?

Answer 6

• Non-dihydropyridine Ca channel blockers e.g. verapamil – causes heart failure, bradycardia, asystole

Question 7

How are beta blockers eliminated?

Answer 7

Kidney

Question 8

What patient information should be given for patients on beta blockers?

Answer 8

• COPD patient – if experiencing breathing difficulties then stop treatment and seek medical advice