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Beta blockers are readily titrated to optimal rate control in many pathologic states. [citation needed] 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.
Propranolol is a medication of the beta blocker class. [2] It is used to treat high blood pressure, a number of types of irregular heart rate, thyrotoxicosis, capillary hemangiomas, performance anxiety, and essential tremors, [2] [3] [4] as well to prevent migraine headaches, and to prevent further heart problems in those with angina or previous heart attacks. [2]
The treatment with β-blockers reduces the incidence of sudden heart failure when the patient has already had a myocardial infarction. The reason is probably because of their anti-arrhythmic effects and also anti-ischemic effects. [10] A β-blocker therapy is also useful in myocardial infarction, independent to heart failure.
Bisoprolol. Bisoprolol, sold under the brand name Zebeta among others, is a beta blocker which is selective for the beta-1 receptor [7] and used for cardiovascular diseases, [7] including tachyarrhythmias, high blood pressure, angina, and heart failure. [7][8] It is taken by mouth. [7]
Atenolol is classified as a beta blocker with low lipophilicity and hence lower potential for crossing the blood–brain barrier and entering the brain. [44] This in turn may result in fewer effects in the central nervous system as well as a lower risk of neuropsychiatric side effects. [44]
Beta-blockers can block beta-1 adrenergic receptors and/or beta-2 adrenergic receptors. Those that block beta-1-adrenergic receptors prevent the binding of endogenous catecholamines (such as epinephrine and norepinephrine), which ultimately reduces blood pressure through decreasing renin and cardiac output release.
The cardio-selective beta-1 blockers could cause adverse effects including bradycardia, reduced exercise ability, hypotension, atrioventricular nodal blockage and heart failure. [5] Other possible adverse effects include nausea and vomiting , abdominal discomfort , dizziness , weakness , headache , fatigue , and dryness in mouth and eye . [ 5 ]
Metoprolol is a beta blocker, or an antagonist of the β-adrenergic receptors. It is specifically a selective antagonist of the β 1 -adrenergic receptor and has no intrinsic sympathomimetic activity. [37] Metoprolol exerts its effects by blocking the action of certain neurotransmitters, specifically adrenaline and noradrenaline.