Beta Blockers

Beta Blockers

Podcast for Beta blockers

Brands and Generics for Beta Blockers, drugs that blocks responses to epinephrine/adrenalin stimulation of beta-adrenergic receptors and results in decreasing heart rate, myocardial contractility and myocardial oxygen demand. Used to treat arrhythmias, angina, hypertension, glaucoma, and migraines.

acebutolol Sectral
atenolol Tenormin
metoprolol succinateToprol XL
metoprolol tartrateLopressor
Nadolol Corgard


Beta Blockers:  also known as  

  • beta-adrenergic blocking agents
  • beta antogonists
  • beta adrenergic antagonists

Used to decrease heart rate by decreasing cardiac output. Beta blockers are used to treat a variety of conditions, such as

  • HTN,
  • Angina,
  • Arrthymias,
  • cardiomyopathy,
  • CHF,
  • heart attack.


  • Can also be prescribed to help treat Migraines, Glaucoma, tremors, overactive thyroid, and anxiety.

The Sympathetic (fight or flight) and parasympathetic (slows): remember that the sympathetic nervous system activates the fight or flight response in the body.  Beta blockers block the action of the sympathetic nervous system of the heart thereby reducing the stress on the heart.

Beta blockers work by blocking the effects of epinephrine aka adrenaline and norepinephrine. Since beta blockers act on blocking epinephrine aka adrenaline, it slows the heart rate which decreases the force of contractions of the heart muscles which reduces the heart’s need for o2.

Beta Blockers are a negative chronotrope. There are several different types of beta blockers:

  • Beta 1 blockers – works on the heart and kidneys
  • Beta 2 blockers – works on lungs, liver, smooth muscle, skeletal muscle
  • Beta 3 – fat cells

Types of beta blockers

Beta blockers medications, (generic name) end on “LOL”


  • 1st generation – Non-selective beta blockers: effect the heart, lungs, liver, kidneys, vascular smooth muscle and skeletal muscle.
  • Bucindolol
  • Carteolol
  • Carvedilol (has additional α-blocking activity)
  • Labetalol (has additional α-blocking activity)
  • Nadolol
  • Oxprenolol (has intrinsic sympathomimetic activity)
  • Penbutolol (has intrinsic sympathomimetic activity)
  • Pindolol (has intrinsic sympathomimetic activity)
  • Propranolol
  • Sotalol
  • Timolol


  • 2nd generation – Cardio selective beta blockers: blocks beta one receptors but in high doses can also block beta 2 receptors. Utilized best with patients who have diabetes and chronic lung disease.


Also known as cardioselective

  • Acebutolol (has intrinsic sympathomimetic activity)
  • Atenolol
  • Betaxolol
  • Bisoprolol
  • Celiprolol
  • Esmolol[52]
  • Metoprolol
  • Nebivolol


Beta blockers are Indicated for use in:


-HTN: as it reduces the arterial blood pressure by decreasing cardiac output

– Angina (Chest Pain) by decreasing the force of contractions of the heart muscles which reduces the heart’s need for o2.

-cardiac arrhythmias (abnormal heart rhythms) decrease the sinus rate (SA Node)

– Heart attack

– Heart failure: (used to be contraindicated, because they were thought to worsen the condition, however, studies in 1990’s that they actually reduced mortality and morbidity by 4.5%)


Children with HF, hypertension, migraines, and irregular heartbeats have been treated with beta blockers

Adverse side effects

  • Bradycardia (under 60 beats per minute).
  • Hypotension (decreased blood pressure)
  • Fatigue
  • n/v/d
  • shortness of breath
  • impotence
  • cold hands


Overuse of beta blockers is treated with glucagon as it will increase the strength of heart contractions. Pacing is sometimes utilized if unresponsive to pharmaceutical therapy.


Use with caution in pregnant women, may slow fetus heart rate, blood pressure, and blood sugar. Can pass via breast milk to infant.

Patients with Bradycardia and/or partial AV block

Patients with asthma or COPD

Patients with diabetes as beta blockers can mask tachycardia

Patients with history of cocaine use




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