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All BB have similar MOA
- competitive blockade of Beta Adrenergic receptors.
- Results in decreased heart rate, myocardial contractility, blood pressure, and myocardial oxygen demand.
Effects of Beta Blockade
- decreased CO and HR
- Slowing of AV conduction system prevents increase in cardiac automaticity and prolongs refractory period.
- BP is lowered by decreasing CO, PVR, venous return, plasma volume, and renin release.
BB also decrease _______damage of the ______?
BB must be used with caution in?
- Any type of heart block
- sinus bradycardia
- cardiogenic shock
Use caution with diabetes!!!! RISK OF DEVELOPING DIABETES IS HIGH!! This is the reason that BB are not considered first line treatment with HTN.
BB are the treatment of choice for _____ and _______?
chronic and unstable angina
Goal is to reduce frequency and severity of signs and symptoms, and to improve exercise capacity without significant side effects.
AHA recommends all patients receive a BB _______?
- Post MI
- Improves survival rate.
BB and migraine headaches
- reduce frequency and intensity of headache.
- propranolol, nadolol, and atenolol.
BB and weight gain
- Because BB slow heart rate and bp, this leads to decreased metabolism, which can lead to weight gain.
- long term BB treatment=11% weight gain
Patient education on BB and impotence
Inform patient that this will resolve and not to quit taking their medication. Should resolve in 7-10 days.
Do not give what with BB
NSAIDS- they interact with each other!!!
Atenolol is pregnancy category
Alpha 1 site
1. smooth muscle in blood vessels, stomach, and intestine
1. vasoconstriction, decreased motility, and tone.
2. Increase renin secretion, increased BP, leads to HTN.
3. gluconeogenesis- break down of sugar in the liver.
Alpha 2 adrenergic receptors effect
- cardiac effect- increased rate and force of contraction
- kidney-increased renin secretion
1.bronchial, vascular, coronary, arteriole, uterine, smooth muscle, and skeletal muscle
- 1. vasodilation
- 2. decreased secretions
- 3. gluconeogenesis
- uncompensated HF- may further depress cardiac contractility
- cardiogenic shock
- bradycardia or HB
- pulmonary edema
- severe asthma and COPD- don't give to patients with bronchospastic disease
- Raynauds disease
- 40 mg bid
- titrate every 3-7 days
- usual dose is 40-160 mg dose in two doses.
- SR is 60-180 mg once daily.
- anaphylaxis of this medication has caused death!!
Teach patient to report which symptoms while taking BB
leg swelling, SOB, exercise fatigue and nocturnal cough