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Figure 1: The chemical structure of dichloroisoprenaline or dichloroisoproterenol (), abbreviated DCI — the first β-blocker to be developed. β adrenergic receptor antagonists (also called beta-blockers or β-blockers) were initially developed in the 1960s, for the treatment of angina pectoris but are now also used for hypertension, congestive heart failure and certain arrhythmias. [1]
There are five adrenergic receptors, which are divided into two groups. The first group of receptors are the beta (β) adrenergic receptors. There are β 1, β 2, and β 3 receptors. The second group contains the alpha (α) adrenoreceptors. There are only α 1 and α 2 receptors.
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 ]
Betaxolol also shows greater affinity for beta 1 receptors than metoprolol. In addition to its effect on the heart, betaxolol reduces the pressure within the eye ( intraocular pressure ). This effect is thought to be caused by reducing the production of the liquid (which is called the aqueous humor ) within the eye.
Beta blockers vary in their lipophilicity (fat solubility) and in turn in their ability to cross the blood–brain barrier and exert effects in the central nervous system. [76] Beta blockers with greater blood–brain barrier permeability can have both neuropsychiatric therapeutic benefits and side effects, as well as adverse cognitive effects ...
Beta-blockers with intrinsic sympathomimetic activity: acebutolol, pindolol; Some common side effects include increased airway resistance for non-selective beta-blockers, exacerbation of peripheral vascular diseases, and hypotension [15] Beta-blockers are contraindicated in patients with second- or third-degree atrioventricular block.
Beta blockers exert their pharmacological effect, decreased heart rate, by binding to and competitively antagonising a type of receptor called beta adrenoceptors. [1]In pharmacology, the term mechanism of action (MOA) refers to the specific biochemical interaction through which a drug substance produces its pharmacological effect. [2]
A Beta-2 adrenergic antagonist (β 2-adrenoceptor antagonist) is an adrenergic antagonist which blocks the beta-2 adrenergic receptors of cells, with either high specificity (an antagonist which is selective for β 2 adrenoceptors) like Butaxamine and ICI-118,551, or non-specifically (an antagonist for β 2 and for β 1 or β 3 adrenoceptors) like the non-selective betablocker Propranolol.