Beta blockers are the group of medications used to treat hypertension (high blood pressure), angina, heart attack, arrhythmias, pheochromocytoma and migraine headaches.
They work by inhibiting the beta adrenergic (beta 1, 2 and 3 or β1, β2 and β3) and some other receptors in the body. Some of these medications are selective and inhibit just some of beta receptors and some work by inhibiting all types of beta receptors.
These are the most commonly used beta blockers:Propranolol, Sotalol, Timolol, Pindolol, Atenolol, Acebutolol, Metoprolol, Bisoprolol, Esmolol, Labetalol, Carvedilol.
Propranolol works by blocking all beta receptors (weakly affecting beta 3) and by stabilizing the cell membrane. It affects the heart, brain and respiratory tract, and possesses metabolic and local anesthetic properties. This medication also affects the eyes and skeletal muscles. It is used to treat: hypertension, angina, heart attack (after the infarction, as a prophylaxis), anxiety, pheochromocytoma, arrhythmias, overactive thyroid gland, tremors, and migraine. Propranolol should not be used in asthma, coronary artery disease, heart block patients and in people suffering from congestive cardiac failure.
Beta blockers are usually well tolerated and have few adverse effects. Propranolol side effects include: bradycardia (lowered heart rate), peripheral vascular problems, tiredness, lethargy, decreased energy, myocardial insufficiency and problems with blood lipids. It could also affect some preexisting conditions, such as obstructive lung disease and borderline diabetes.
Metoprolol is one of the prototypes of beta blockers. It is often used when the patients can’t tolerate the side effects of propranolol, such as cold hands and feet. It is the preferable beta blocker to be used in diabetic patients.
Sotalol is also a non-selective beta blocker that also blocks potassium channels in the heart. It is often used to treat severe arrhythmias.
It shouldn’t be used in children, pregnant women, nursing mothers or patients with kidney problems. People experiencing diarrhea and other electrolyte misbalance diseases should also avoid the use of this medication. Sotalol might cause arrhythmias, hypotension, drowsiness and dizziness. The drug interferes with many other medications and should be carefully prescribed.
Timolol is used in the same diseases as other beta blockers, but it is also prescribed in patients suffering from glaucoma and different eye problems. In these patients, timolol is used as eye drops and to reduce the eye pressure. During this use, timolol might provoke stinging or the pain, and these symptoms require the consult with your ophthalmologist.
Other Beta Blockers
Pindolol is primarily hypertension medication, especially for the patients that can’t tolerate propranolol. It shouldn’t be used in people with kidney problems, heart failure, diabetes or in nursing mothers.
Atenolol is a cardioselective beta blocker, which means it affects just the heart. It is prescribed to treat angina, heart attack, tachycardia, tremors and migraine. It shouldn’t be used with calcium channel blockers or in pregnant women.
Acebutol is a cardioselective beta blocker. A single dose of this drug is usually working for all patients. This medication is safe to be used in asthma and COPD (chronic obstructive pulmonary disease) patients.
Esmolol is used to temporary treat urgent medical conditions, such as tachycardia, arrhythmia, and heart attack, and also in the heart surgery. It is usually given intravenously and the effects last for 10 minutes.
Other beta blockers in use are bisoprolol, labetalol and carvedilol.