PEBC: What You Need to Know: Beta-blockers

Cardioselective (works only on the heart - beta-1): acebutolol, atenolol, bisoprolol, metoprolol

Non-selective (beta-1 and beta-2): nadolol, pindolol, propranolol

Indications:

Mostly for hypertension, post-MI, heart rate control in atrial fibrillation

Other indications: performance anxiety, migraine prevention

Not first line for hypertension over 60 years old unless there is a specific compelling indication

Adverse Effects:

-Dizziness

-Bradycardia (reduces heart rate)

-Fatigue

-Cold extremities

-Increased lipids

-Delayed response to hypoglycemia

-Asthma bronchospasm (more likely with non-selective agents)

-Exercise intolerance

Drug Interactions:

Rebound hypertension/tachycardia upon discontinuation of alpha blockers and clonidine

Calcium channel blockers, digoxin, amiodarone- increased risk of bradycardia