B blockers
B adrenergic blockers of Sympa NS.
3 receptor types
- β1 adrenergic receptors – heart , renal
- β2 on lung, GI, vascular SM
receptor selectivity reduces at higher doses
Cardio v non cardioselective
Bisoprolol
Nebivolol
Propranolol
Indic
- Anxiety
- A Fib etc
- Tremor esp Hyperthyroidism
- Migraine prophylaxis
- Heart failure
- 2nd line HTN
- Post MI
- IHD
- Glaucoma
C/I
- Asthma
- Heart block
- PVD
- Acute heart failure – may precipitate
- Raynauds
- Cocaine overdose
Side effects
- Fatigue
- ED
- Cold extremities
- Memory difficulties
- Weight gain
- Hypotension
- Bradycardia
- Bronchospasm
- Bb induced hypoglycaemic unawareness (no fast HR)
- Blocks aldosterone so can cause ↑K and ↓Na
- May worsen lipid profile.
Interactions