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Skeletal formula of propranolol, the first clinically successful beta blocker
Skeletal formula of propranolol, the first clinically successful beta blocker

Beta blockers (sometimes written as β-blocker) are a class of drugs used for various indications, but particularly for the management of cardiac arrhythmias and cardioprotection after myocardial infarction. The skeletal formula of an Organic compound is a shorthand representation of its molecular structure. Propranolol ( INN) is a non-selective Beta blocker mainly used in the treatment of Hypertension. Medication, also referred to as medicine, can be loosely defined as any substance intended for use in the diagnosis cure mitigation treatment or prevention of disease Dysrhythmia redirects here For the American band see Dysrhythmia (band. Myocardial infarction ( MI or AMI for acute myocardial infarction) also known as a heart attack, occurs when the blood supply Whilst once first-line treatment for hypertension, their role was downgraded in June 2006 in the United Kingdom to fourth-line as they did not perform as well as other drugs, particularly in the elderly with erectile dysfunction and anal seepage, and there is increasing evidence that the most frequently used beta-blockers especially in combination with thiazide-type diuretics carry an unacceptable risk of provoking type 2 diabetes. Hypertension, also referred to as high blood pressure, HTN or HPN, is a medical condition in which the Blood pressure is chronically elevated The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom, the UK or Britain,is a Sovereign state located Steatorrhea is the presence of excess fat in Feces. Stools may also float due to excess gas have an oily appearance and be foul smelling Thiazide is a term used to describe a type of molecule and a class of Diuretic. Diabetes mellitus type 2 or Type 2 Diabetes (formerly called non - Insulin -dependent Diabetes mellitus (NIDDM or adult-onset diabetes is a metabolic [1] However, Forest Laboratories and Mylan Inc. announced on December 18, 2007 the novel beta blocker Bystolic was approved by the FDA for treatment of hypertension.

Propranolol was the first clinically useful beta adrenergic receptor antagonist. Propranolol ( INN) is a non-selective Beta blocker mainly used in the treatment of Hypertension. A receptor antagonist is a type of receptor ligand or Drug that does not provoke a biological response itself upon binding to a receptor, but blocks Invented by Sir James W. Black, it revolutionized the medical management of angina pectoris and is considered to be one of the most important contributions to clinical medicine and pharmacology of the 20th century. Sir James Whyte Black, OM, FRS, FRSE, FRCP (born 14 July 1924) is a Scottish doctor and pharmacologist Angina pectoris, commonly known as angina, is severe Chest pain due to Ischemia (a lack of blood and hence Oxygen supply of the heart Pharmacology (from Greek grc φάρμακον pharmakon, "drug" and grc -λογία -logia) is the study of how Drugs [2]

Beta blockers may also be referred to as beta-adrenergic blocking agents, beta-adrenergic antagonists, or beta antagonists.

Contents

Pharmacology

Beta blockers block the action of endogenous catecholamines (epinephrine (adrenaline) and norepinephrine (noradrenaline) in particular), on β-adrenergic receptors, part of the sympathetic nervous system which mediates the fight or flight response. The word endogenous means "arising from within" the opposite of Exogenous. Norepinephrine ( INN) (abbreviated norepi or NE) or noradrenaline ( BAN) (abbreviated NA or NAd) is a The adrenergic receptors (or adrenoceptors) are a class of G protein-coupled receptors that are targets of the Catecholamines Adrenergic receptors The Sympathetic Nervous System ( SNS) is a branch of the Autonomic nervous system along with the Enteric nervous system and Parasympathetic nervous The fight-or-flight response', also called the fright, fight or flight response, hyperarousal or the acute stress response, was first

There are three known types of beta receptor, designated β1, β2 and β3. β1-Adrenergic receptors are located mainly in the heart and in the kidneys. β2-Adrenergic receptors are located mainly in the lungs, gastrointestinal tract, liver, uterus, vascular smooth muscle, and skeletal muscle. β3-receptors are located in fat cells.

Examples of beta-blockers include: Sectral (acebutolol), Zebeta (bisoprolol), Brevibloc (esmolol), Inderal (propranolol), Tenormin (atenolol), Normodyne (labetalol), Coreg (carvedilol), Lopressor (metoprolol), and Bystolic (nebivolol).

β-Receptor antagonism

Stimulation of β1 receptors by epinephrine induces a positive chronotropic and inotropic effect on the heart and increases cardiac conduction velocity and automaticity. Chronotropic effects (from chrono-, meaning time are those that change the Heart rate. An inotrope (ˈaɪnətroʊp is an agent that alters the force or energy of Muscular contractions Negatively inotropic agents weaken the force of muscular contractions Stimulation of β1 receptors on the kidney causes renin release. Stimulation of β2 receptors induces smooth muscle relaxation (resulting in vasodilation and bronchodilation amongst other actions), induces tremor in skeletal muscle, and increases glycogenolysis in the liver and skeletal muscle. Smooth muscle is a type of non- Striated muscle, found within the Tunica media layer of large and small Arteries and Veins, the bladder A bronchodilator is a substance that dilates the bronchi and Bronchioles decreasing airway resistance and thereby facilitating airflow Skeletal muscle is a type of Striated muscle, which usually attaches to tendons Glycogenolysis (also known as "Glycogenlysis" is the Catabolism of Glycogen by removal of a Glucose monomer through cleavage with inorganic The liver is a vital organ in the human body and is present in Vertebrates and some other animals Skeletal muscle is a type of Striated muscle, which usually attaches to tendons Stimulation of β3 receptors induces lipolysis. Lipolysis is the breakdown of fat stored in fat cells During this process Free fatty acids are released into the bloodstream and circulate throughout the body

Beta blockers inhibit these normal epinephrine-mediated sympathetic actions, but have minimal effect on resting subjects. The Sympathetic Nervous System ( SNS) is a branch of the Autonomic nervous system along with the Enteric nervous system and Parasympathetic nervous That is, they reduce the effect of excitement/physical exertion on heart rate and force of contraction, dilation of blood vessels and opening of bronchi, and also reduce tremor and breakdown of glycogen. Glycogen is a Polysaccharide of Glucose (Glc which functions as the secondary short term energy storage in Animal cells

It is therefore expected that non-selective beta blockers have an antihypertensive effect. Antihypertensives are a class of drugs that are used in Medicine and Pharmacology to treat Hypertension (high blood pressure The antihypertensive mechanism appears to involve: reduction in cardiac output (due to negative chronotropic and inotropic effects), reduction in renin release from the kidneys, and a central nervous system effect to reduce sympathetic activity (for those β-blockers that do cross the blood-brain barrier, e. Renin (pronounced "Ree-nin" or "Rē-nin" (ˈriːnɨn also known as Angiotensinogenase, is a circulating Enzyme that participates in the body's In Vertebrates the central nervous system ( CNS) is the part of the Nervous system which is enclosed in the Meninges. The Sympathetic Nervous System ( SNS) is a branch of the Autonomic nervous system along with the Enteric nervous system and Parasympathetic nervous g. Propranolol).

Antianginal effects result from negative chronotropic and inotropic effects, which decrease cardiac workload and oxygen demand. Chronotropic effects (from chrono-, meaning time are those that change the Heart rate. An inotrope (ˈaɪnətroʊp is an agent that alters the force or energy of Muscular contractions Negatively inotropic agents weaken the force of muscular contractions

The antiarrhythmic effects of beta blockers arise from sympathetic nervous system blockade – resulting in depression of sinus node function and atrioventricular node conduction, and prolonged atrial refractory periods. The Sinoatrial node (abbreviated SA node or SAN, also called the sinus node) is the impulse generating (pacemaker tissue located in the Right atrium The atrioventricular node (abbreviated AV node) is an area of specialized tissue between the atria and the ventricles of the Heart, specifically In Anatomy, the atrium (plural atria) refers to a chamber or space In Physiology, a refractory period is a period of time during which an organ or cell is incapable of repeating a particular action or (more precisely the amount of time Sotalol, in particular, has additional antiarrhythmic properties and prolongs action potential duration through potassium channel blockade. Sotalol (trade names Betapace and Betapace AF, Berlex Laboratories, Sotalex and Sotacor, Bristol-Myers Squibb) is a In Neurophysiology, the action potential is a self-regenerating Wave of Electrochemical activity that allows Nerve cells to carry a signal In the field of Cell biology, potassium channels are the most widely distributed type of Ion channel and are found in virtually all living organisms

Blockade of the sympathetic nervous system on renin release leads to reduced aldosterone via the renin angiotensin aldosterone system with a resultant decrease in blood pressure due to decreased sodium and water retention. The renin-angiotensin system (RAS or the renin-angiotensin-aldosterone system (RAAS is a hormone system that regulates Blood pressure and water ( fluid

Intrinsic sympathomimetic activity

Some beta blockers (e. g. oxprenolol and pindolol) exhibit intrinsic sympathomimetic activity (ISA). Oxprenolol is a non-selective Beta blocker with some intrinsic sympathomimetic activity Pindolol is a Beta blocker drug Pharmacology Pindolol is a nonselective beta blocker with partial beta-agonist activity These agents are capable of exerting low level agonist activity at the β-adrenergic receptor while simultaneously acting as a receptor site antagonist. An agonist is a term used to describe a type of ligand or drug that binds and alters the activity of a receptor. A receptor antagonist is a type of receptor ligand or Drug that does not provoke a biological response itself upon binding to a receptor, but blocks These agents, therefore, may be useful in individuals exhibiting excessive bradycardia with sustained beta blocker therapy. Bradycardia, as applied to adult medicine is defined as a resting Heart rate of under 60 beats per minute though it is seldom symptomatic until the rate drops below 50 beat/min

Agents with ISA are not used in post-myocardial infarction as they have not been demonstrated to be beneficial. Myocardial infarction ( MI or AMI for acute myocardial infarction) also known as a heart attack, occurs when the blood supply They may also be less effective than other beta blockers in the management of angina and tachyarrhythmia. Angina pectoris, commonly known as angina, is severe Chest pain due to Ischemia (a lack of blood and hence Oxygen supply of the heart Dysrhythmia redirects here For the American band see Dysrhythmia (band. [3]

α1-Receptor antagonism

Some beta blockers (e. g. labetalol and carvedilol) exhibit mixed antagonism of both β- and α1-adrenergic receptors, which provides additional arteriolar vasodilating action. Labetalol ( Normodyne, Trandate, fixed combination with Hydrochlorothiazide: Normozyde) is a Drug that is a Racemic mixture Carvedilol is a non-selective beta blocker indicated in the treatment of mild to moderate Congestive heart failure (CHF The adrenergic receptors (or adrenoceptors) are a class of G protein-coupled receptors that are targets of the Catecholamines Adrenergic receptors An arteriole is a small diameter Blood vessel that extends and branches out from an Artery and leads to capillaries.

Other effects

Beta blockers decrease nocturnal melatonin release, perhaps partly accounting for sleep disturbance caused by some agents. Melatonin is a naturally occurring Hormone found in most animals including humans and some other living organisms including Algae. [4] Beta blockers protect against social anxiety: "Improvement of physical symptoms has been demonstrated with beta-blockers such as propranolol; however, these effects are limited to the social anxiety experienced in performance situations. " (example- an inexperienced symphony soloist) [5] Beta blockers can impair the relaxation of bronchial muscle (mediated by beta-2) and so should be avoided by asthmatics.

Clinical use

Large differences exist in the pharmacology of agents within the class, thus not all beta blockers are used for all indications listed below.

Indications for beta blockers include:

Beta blockers have also been used in the following conditions:

Congestive heart failure

Although beta blockers were once contraindicated in congestive heart failure, as they have the potential to worsen the condition, studies in the late 1990s showed their positive effects on morbidity and mortality in congestive heart failure. Hypertension, also referred to as high blood pressure, HTN or HPN, is a medical condition in which the Blood pressure is chronically elevated Angina pectoris, commonly known as angina, is severe Chest pain due to Ischemia (a lack of blood and hence Oxygen supply of the heart Mitral valve prolapse (MVP is a Valvular heart disease characterized by the displacement of an abnormally thickened Mitral valve leaflet into the left atrium Dysrhythmia redirects here For the American band see Dysrhythmia (band. Heart failure is a Cardiac condition that occurs when a problem with the structure or function of the Heart impairs its ability to supply Myocardial infarction ( MI or AMI for acute myocardial infarction) also known as a heart attack, occurs when the blood supply Glaucoma is a group of diseases of the Optic nerve involving loss of retinal ganglion cells in a characteristic pattern of optic neuropathy. Migraine is a neurological Syndrome characterized by altered bodily experiences painful headaches and nausea Prophylaxis ( Greek "προφυλάσσω" to guard or prevent beforehand) is any medical or Public health procedure whose purpose Tremor is an unintentional somewhat rhythmic muscle movement involving to-and-from movements (oscillations of one or more parts of the body Anxiety is a physiological and psychological state characterized by Cognitive, Somatic, Emotional and Behavioral components Hyperthyroidism is the term for overactive tissue within the Thyroid gland resulting in overproduction and thus an excess of circulating free thyroid hormones Thyroxine Essential tremor ( ET) is a progressive Neurological disease whose most recognizable feature is a tremor of the Arms that is apparent during voluntary movements A phaeochromocytoma ( pheochromocytoma in the US is a Neuroendocrine tumor of the medulla of the Adrenal glands (originating in the Chromaffin Alpha blockers (or adrenergic alpha-antagonists) are agents that act as antagonists of alpha adrenergic receptors Classification They can be divided Cardiomyopathy, which literally means "heart muscle disease" is the deterioration of the function of the Myocardium (i Marfan syndrome (or Marfan's syndrome is a genetic disorder of the Connective tissue. In Medicine, portal hypertension is Hypertension (high blood pressure in the Portal vein and its branches Primary hyperhidrosis is the condition characterized by abnormally increased Perspiration, in excess of that required for regulation of Body temperature. Social phobia (DSM-IV 30023 also known as social anxiety disorder (DSM-IV 300 Anxiety disorder is a blanket term covering several different forms of abnormal pathological anxieties Fears and Phobias In clinical usage "fear" Heart failure is a Cardiac condition that occurs when a problem with the structure or function of the Heart impairs its ability to supply [6] [7] [8] Bisoprolol, carvedilol and sustained-release metoprolol are specifically indicated as adjuncts to standard ACE inhibitor and diuretic therapy in congestive heart failure. Bisoprolol is a drug belonging to the group of Beta blockers a class of drugs used primarily in Cardiovascular diseases More specifically it is a selective type β1 Carvedilol is a non-selective beta blocker indicated in the treatment of mild to moderate Congestive heart failure (CHF Metoprolol is a selective β1 receptor blocker used in treatment of several diseases of thecardiovascular system especially Hypertension. ACE inhibitors, or inhibitors of '''A'''ngiotensin-'''C'''onverting '''E'''nzyme, are a group of Pharmaceuticals that are used primarily in treatment of Hypertension A diuretic is any Drug that elevates the rate of urination ( Diuresis)

Beta blockers are primarily known for their reductive effect on heart rate, although this is not necessarily the case. Beta blockers don't directly interact with the heart at all, but instead influence the renin/ angiotensin system at the kidneys. Beta blockers specifically cause a decrease in renin secretion, which in turn reduce the heart oxygen demand by lowering extracellular volume. Beta blockers have also been a benefit to improving the ejection fraction of the heart despite an initial reduction in it.

Trials have shown that Beta blockers reduce the absolute risk of death by 4. 5% over a 13 month period. As well as reducing the risk of mortality, the number of hospital visits and hospitalizations were also reduced in the trials. [9]

Anxiety and performance enhancement

Some people, particularly musicians, use beta blockers to avoid stage fright and tremor during public performance and auditions. A musician is a person who plays or writes Music. Musicians can be classified by their roles in creating or performing music An instrumentalist plays a Stage fright or performance anxiety refers to an Anxiety, Fear or persistent Phobia related to Performance in front of An audition is a sample performance by an Actor, Singer, Musician, Dancer or other performer The physiological symptoms of the fight/flight response associated with performance anxiety and panic (pounding heart, cold/clammy hands, increased respiration, sweating, etc. Stage fright or performance anxiety refers to an Anxiety, Fear or persistent Phobia related to Performance in front of For psychological condition see Panic attack Panic is a sudden Fear which dominates or replaces thinking and often affects groups of ) are significantly reduced, thus enabling anxious individuals to concentrate on the task at hand. Officially, beta blockers are not approved for anxiolytic use by the U. An anxiolytic is a drug prescribed for the treatment of Symptoms of Anxiety. S. Food and Drug Administration. [10]

Since they lower heart rate and reduce tremor, beta blockers have been used by some Olympic marksmen to enhance performance, though beta blockers are banned by the International Olympic Committee (IOC). The Olympic Games is an international Multi-sport event established for both summer and winter games A marksman is a person that is skilled in Precision shooting, using projectile weapons such as with a Rifle but most commonly with a Sniper rifle, [11] Although they have no recognisable benefit to most sports, it is acknowledged that they are beneficial to sports such as archery and shooting.

Adverse effects

Adverse drug reactions (ADRs) associated with the use of beta blockers include: nausea, diarrhea, bronchospasm, dyspnea, cold extremities, exacerbation of Raynaud's syndrome, bradycardia, hypotension, heart failure, heart block, fatigue, dizziness, abnormal vision, decreased concentration, hallucinations, insomnia, nightmares, clinical depression, sexual dysfunction, erectile dysfunction and/or alteration of glucose and lipid metabolism. An adverse drug reaction (abbreviated ADR) or adverse drug event (abbreviated ADE) is an expression that describes the unwanted negative consequences Nausea ( Latin: Nausea, Greek:, " Sea-sickness " also called wamble) is the sensation of unease and discomfort In Medicine, diarrhea, also spelled diarrhoea (see spelling differences) is frequent loose or liquid Bowel movements Acute diarrhea Bronchospasm is a sudden constriction of the muscles in the walls of the Bronchioles It is caused by the release ( Degranulation) of substances from Mast cells Dyspnea or dyspnoea (pronounced disp-nee-ah, IPA /dɪsp'niə/ from Latin dyspnoea, from Greek dyspnoia from Raynaud's phenomenon (reɪˈnoʊz (rāy-NŌZ in Medicine, is a vasospastic disorder causing discoloration of the Fingers Toes and occasionally Bradycardia, as applied to adult medicine is defined as a resting Heart rate of under 60 beats per minute though it is seldom symptomatic until the rate drops below 50 beat/min In Physiology and Medicine, hypotension refers to an abnormally low Blood pressure. Heart failure is a Cardiac condition that occurs when a problem with the structure or function of the Heart impairs its ability to supply A heart block is a disease in the electrical system of the Heart. Many different terms are often used to describe what is collectively known as dizziness. A hallucination, in the broadest sense is a Perception in the absence of a stimulus. Insomnia is a symptom of a sleeping disorder characterized by persistent difficulty falling asleep or staying asleep despite the opportunity Major depressive disorder, also known as major depression, unipolar depression, unipolar disorder, clinical depression, or simply depression Sexual dysfunction or sexual malfunction (see also Sexual function) is difficulty during any stage of the Sexual act (which includes desire, Glucose (Glc a Monosaccharide (or simple Sugar) also known as grape sugar, is an important Carbohydrate in Biology. Lipids are broadly defined as any fat- Soluble ( lipophilic) naturally-occurring Molecule, such as fats oils waxes cholesterol sterols fat-soluble Metabolism is the set of Chemical reactions that occur in living Organisms in order to maintain Life. Mixed α1/β-antagonist therapy is also commonly associated with orthostatic hypotension. Orthostatic hypotension (also known as postural hypotension, and colloquially as head rush or a dizzy spell) is a form of Hypotension in which Carvedilol therapy is commonly associated with edema. Carvedilol is a non-selective beta blocker indicated in the treatment of mild to moderate Congestive heart failure (CHF Oedema (or Edema in American English formerly known as dropsy or hydropsy, is the increase of Interstitial fluid in any organ &mdash swelling [3]

Central nervous system (CNS) adverse effects (hallucinations, insomnia, nightmares, depression) are more common in agents with greater lipid solubility, which are able to cross the blood-brain barrier into the CNS. In Vertebrates the central nervous system ( CNS) is the part of the Nervous system which is enclosed in the Meninges. The blood-brain barrier (BBB is a metabolic or cellular structure in the Central nervous system (CNS that restricts the passage of various chemical substances and microscopic Similarly, CNS adverse effects are less common in agents with greater aqueous solubility (listed below).

Adverse effects associated with β2-adrenergic receptor antagonist activity (bronchospasm, peripheral vasoconstriction, alteration of glucose and lipid metabolism) are less common with β1-selective (often termed "cardioselective") agents, however receptor selectivity diminishes at higher doses. Beta blockade, especially of the beta-1 receptor at the macula densa inhibits renin release, thus decreasing the release of aldosterone. This causes hyponatremia and hyperkalemia.

A 2007 study revealed that diuretics and beta-blockers used for hypertension increase a patient's risk of developing diabetes whilst ACE inhibitors and Angiotensin II receptor antagonists (Angiotensin Receptor Blockers) actually decrease the risk of diabetes. Diabetes mellitus (ˌdaɪəˈbiːtiːz or /ˌdaɪəˈbiːtəs/ /məˈlaɪtəs/ or /ˈmɛlətəs/ often referred to simply as diabetes ( Ancient Greek: grc ACE inhibitors, or inhibitors of '''A'''ngiotensin-'''C'''onverting '''E'''nzyme, are a group of Pharmaceuticals that are used primarily in treatment of Hypertension Angiotensin II receptor antagonists, also known as angiotensin receptor blockers (ARBs AT1-receptor antagonists or sartans, are a group of [12] Clinical guidelines in Great Britain, but not in the United States, call for avoiding diuretics and beta-blockers as first-line treatment of hypertension due to the risk of diabetes. [13]

Beta blockers must not be used in the treatment of cocaine, amphetamine, or other alpha adrenergic stimulant overdose. Cocaine ( benzoylmethyl ecgonine) is a Crystalline Tropane Alkaloid that is obtained from the leaves of the Coca plant Amphetamine, and related drugs such as Methamphetamine are a group of drugs that act by increasing levels of Norepinephrine, Serotonin, and Dopamine Stimulant drugs are Drugs that temporarily increase alertness and awareness The term drug overdose (or simply overdose or OD) describes the Ingestion or application of a Drug or other substance in quantities The blockade of only beta receptors increases hypertension, reduces coronary blood flow, left ventricular function, and cardiac output and tissue perfusion by means of leaving the alpha adrenergic system stimulation unopposed. Hypertension, also referred to as high blood pressure, HTN or HPN, is a medical condition in which the Blood pressure is chronically elevated In the Heart, a ventricle is a heart chamber which collects Blood from an atrium (another heart chamber that is smaller than a ventricle and Cardiac output (Q is the volume of blood being pumped by the Heart, in particular by a ventricle in a minute [14] The appropriate antihypertensive drugs to administer during hypertensive crisis resulting from stimulant abuse are vasodilators like nitroglycerin, diuretics like furosemide and alpha blockers like phentolamine. Antihypertensives are a class of drugs that are used in Medicine and Pharmacology to treat Hypertension (high blood pressure Nitroglycerin ( NG) ( US spelling also known as nitroglycerine, ( UK Spelling trinitroglycerin, trinitroglycerine A diuretic is any Drug that elevates the rate of urination ( Diuresis) Furosemide ( INN) or frusemide (former BAN) is a Loop diuretic used in the treatment of congestive Heart failure and Edema Alpha blockers (or adrenergic alpha-antagonists) are agents that act as antagonists of alpha adrenergic receptors Classification They can be divided Phentolamine (Regitine is a reversible nonselective alpha- Adrenergic antagonist. [15]

Examples of beta blockers

Dichloroisoprenaline, the first beta blocker.
Dichloroisoprenaline, the first beta blocker.

Non-selective agents

β1-Selective agents

Mixed α1/β-adrenergic antagonists

β2-Selective agents

Side Effects / Health Consequences

Comparative information

Pharmacological differences

Indication differences

Propranolol is the only agent indicated for control of tremor, portal hypertension and esophageal variceal bleeding, and used in conjunction with α-blocker therapy in phaeochromocytoma. Carteolol (trade name Teoptic) is a Beta blocker used to treat Glaucoma. Levobunolol (trade names AKBeta and Betagan) is a Beta blocker. Metipranolol hydrochloride (OptiPranolol is a non-selective Beta blocker used in Eye drops to treat Glaucoma. Nadolol ( Corgard) is a non-selective Beta-blocker used in the treatment of high blood pressure, migraine headaches, and chest pain Oxprenolol is a non-selective Beta blocker with some intrinsic sympathomimetic activity Penbutolol is a Medication in the class of Beta blockers used in the treatment of high blood pressure. Pindolol is a Beta blocker drug Pharmacology Pindolol is a nonselective beta blocker with partial beta-agonist activity Propranolol ( INN) is a non-selective Beta blocker mainly used in the treatment of Hypertension. Sotalol (trade names Betapace and Betapace AF, Berlex Laboratories, Sotalex and Sotacor, Bristol-Myers Squibb) is a Timolol maleate is a non-selective beta-adrenergic receptor blocker. Acebutolol ( Sectral, Prent) is a Beta blocker for the treatment of Hypertension, angina, and Arrhythmia. Atenolol is a β1 receptor specific antagonist a drug belonging to the group of β-blockers, a class of drugs used primarily in Cardiovascular diseases Betaxolol (trade names Betoptic, Betoptic S, Lokren, Kerlone) is a selective beta1 receptor blocker used in the treatment Bisoprolol is a drug belonging to the group of Beta blockers a class of drugs used primarily in Cardiovascular diseases More specifically it is a selective type β1 Esmolol (trade name Brevibloc) is a cardioselective beta1 receptor blocker with rapid onset a very short duration of action and no significant intrinsic Metoprolol is a selective β1 receptor blocker used in treatment of several diseases of thecardiovascular system especially Hypertension. Nebivolol is a highly cardioselective beta1 receptor blocker with Nitric oxide -potentiating vasodilatory effect used in treatment of Hypertension Carvedilol is a non-selective beta blocker indicated in the treatment of mild to moderate Congestive heart failure (CHF Celiprolol (brand names Cardem Celectol Celipres Celipro Celol Cordiax Dilanorm Selectol is a Medication in the class of Beta blockers used in the treatment Labetalol ( Normodyne, Trandate, fixed combination with Hydrochlorothiazide: Normozyde) is a Drug that is a Racemic mixture Butaxamine ( INN, also known as butoxamine) is a β2-selective Beta blocker. Peyronie's disease is a Connective tissue disorder involving the growth of Fibrous plaques ref name="pmid12514077"> in the Soft tissue of An antioxidant is a Molecule capable of slowing or preventing the oxidation of other molecules Dysrhythmia redirects here For the American band see Dysrhythmia (band. Esmolol (trade name Brevibloc) is a cardioselective beta1 receptor blocker with rapid onset a very short duration of action and no significant intrinsic Sotalol (trade names Betapace and Betapace AF, Berlex Laboratories, Sotalex and Sotacor, Bristol-Myers Squibb) is a Heart failure is a Cardiac condition that occurs when a problem with the structure or function of the Heart impairs its ability to supply Bisoprolol is a drug belonging to the group of Beta blockers a class of drugs used primarily in Cardiovascular diseases More specifically it is a selective type β1 Carvedilol is a non-selective beta blocker indicated in the treatment of mild to moderate Congestive heart failure (CHF Metoprolol is a selective β1 receptor blocker used in treatment of several diseases of thecardiovascular system especially Hypertension. Nebivolol is a highly cardioselective beta1 receptor blocker with Nitric oxide -potentiating vasodilatory effect used in treatment of Hypertension Glaucoma is a group of diseases of the Optic nerve involving loss of retinal ganglion cells in a characteristic pattern of optic neuropathy. Betaxolol (trade names Betoptic, Betoptic S, Lokren, Kerlone) is a selective beta1 receptor blocker used in the treatment Carteolol (trade name Teoptic) is a Beta blocker used to treat Glaucoma. Levobunolol (trade names AKBeta and Betagan) is a Beta blocker. Metipranolol hydrochloride (OptiPranolol is a non-selective Beta blocker used in Eye drops to treat Glaucoma. Timolol maleate is a non-selective beta-adrenergic receptor blocker. Myocardial infarction ( MI or AMI for acute myocardial infarction) also known as a heart attack, occurs when the blood supply Atenolol is a β1 receptor specific antagonist a drug belonging to the group of β-blockers, a class of drugs used primarily in Cardiovascular diseases Metoprolol is a selective β1 receptor blocker used in treatment of several diseases of thecardiovascular system especially Hypertension. Propranolol ( INN) is a non-selective Beta blocker mainly used in the treatment of Hypertension. Migraine is a neurological Syndrome characterized by altered bodily experiences painful headaches and nausea Timolol maleate is a non-selective beta-adrenergic receptor blocker. Propranolol ( INN) is a non-selective Beta blocker mainly used in the treatment of Hypertension. Propranolol ( INN) is a non-selective Beta blocker mainly used in the treatment of Hypertension. In Medicine, portal hypertension is Hypertension (high blood pressure in the Portal vein and its branches A phaeochromocytoma ( pheochromocytoma in the US is a Neuroendocrine tumor of the medulla of the Adrenal glands (originating in the Chromaffin [3]

References

Footnotes

  1. ^ Sheetal Ladva (28/06/2006). NICE and BHS launch updated hypertension guideline. National Institute for Health and Clinical Excellence. Retrieved on 2006-09-30. Year 2006 ( MMVI) was a Common year starting on Sunday of the Gregorian calendar. Events 1399 - Henry IV is proclaimed King of England. 1744 - France and Spain defeat the
  2. ^ Melanie Patricia Stapleton (1997). Sir James Black and Propranolol. Texas Heart Institute Journal.
  3. ^ a b c (2006) in Editor Rossi S: Australian Medicines Handbook. The Australian Medicines Handbook or AMH is a medical reference text commonly used in practice by health professionals (particularly General practitioners Adelaide: Australian Medicines Handbook.  
  4. ^ Stoschitzky K, Sakotnik A, Lercher P, et al (1999). "Influence of beta-blockers on melatonin release". Eur. J. Clin. Pharmacol. 55 (2): 111–5. doi:10.1007/s002280050604. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 10335905.  
  5. ^ Davidson, M. D. , Jonathan; Connor M. D. , Kathryn M. (1999). Social Anxiety Disorder: A Treatable Condition. Drug Benefit Trends 11(5) 5BH-7BH. Cliggott Publishing, Division of SCP Communications. Retrieved on 2007-10-06. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Events 105 BC - Battle of Arausio: The Cimbri inflict the heaviest defeat on the Roman army of Gnaeus Mallius Maximus
  6. ^ Hjalmarson A, Goldstein S, Fagerberg B, et al (2000). "Effects of controlled-release metoprolol on total mortality, hospitalizations, and well-being in patients with heart failure: the Metoprolol CR/XL Randomized Intervention Trial in congestive heart failure (MERIT-HF). MERIT-HF Study Group". JAMA 283 (10): 1295–302. doi:10.1001/jama.283.10.1295. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 10714728.  
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  8. ^ Packer M, Fowler MB, Roecker EB, et al (2002). "Effect of carvedilol on the morbidity of patients with severe chronic heart failure: results of the carvedilol prospective randomized cumulative survival (COPERNICUS) study". Circulation 106 (17): 2194–9. doi:10.1161/01.CIR.0000035653.72855.BF. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 12390947.  
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  14. ^ eMedicine - Toxicity, Cocaine : Article by Carlos J Roldan
  15. ^ eMedicine - Toxicity, Amphetamine : Article by Neal Handly
  16. ^ Bisoprolol MedlinePlus

External links

Medical Subject Headings ( MeSH) is a huge Controlled vocabulary (or metadata system for the purpose of indexing journal articles and books

Dictionary

beta blocker

-noun

  1. (pharmacology) A blocking agent, one of a class of drugs used to treat hypertension and control the rate at which the heart beats.
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