beta adrenergic receptor antagonist (beta-blocker)

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Introduction

A molecule/drug that blocks the effect of catecholamines on beta adrenergic receptors, producing a decrease in heart rate & oxygen demand in the myocardium.

Indications

* no advantage of beta-blockers for preventing myocardial infarction or death when used to treat hypertension[9] or in patients with stable coronary artery disease or cardiovascular risk factors[14]

# not 1st line for uncomplicated hypertension[12]

Contraindications

Caution:

Adverse effects

Overdose:

Drug interactions

Laboratory

Mechanism of action

More general terms

More specific terms

Additional terms

Component of

References

  1. 1.0 1.1 Medical Knowledge Self Assessment Program (MKSAP) 11, 15, 16. American College of Physicians, Philadelphia 1998 2009, 2012
  2. 2.0 2.1 Manual of Medical Therapeutics, 28th ed, Ewald & McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 158-59
  3. 3.0 3.1 Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 474-75, 491
  4. 4.0 4.1 The Washington Manual of Medical Therapeutics, 33rd edition Foster C et al (eds) Lippincott, Williams & Wilkins, Philadelphia, 2010, pg 969
  5. 5.0 5.1 Journal Watch 20(9): 72, 2000 Gress TW, Nieto FJ, Shahar E, Wofford MR, Brancati FL. Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. Atherosclerosis Risk in Communities Study. N Engl J Med. 2000 Mar 30;342(13):905-12. PMID: https://www.ncbi.nlm.nih.gov/pubmed/10738048
  6. Prescriber's Letter 12(4): 2005 Comparison of Beta-Blockers Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=210410&pb=PRL (subscription needed) http://www.prescribersletter.com
  7. 7.0 7.1 Prescriber's Letter 12(7): 2005 Should Some Drugs Be Avoided in Patients at Risk of Anaphylaxis? Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=210714&pb=PRL (subscription needed) http://www.prescribersletter.com
  8. Lanfear DE, Jones PG, Marsh S, Cresci S, McLeod HL, Spertus JA. Beta2-adrenergic receptor genotype and survival among patients receiving beta-blocker therapy after an acute coronary syndrome. JAMA. 2005 Sep 28;294(12):1526-33. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16189366
  9. 9.0 9.1 Lindholm LH, Carlberg B, Samuelsson O. Should beta blockers remain first choice in the treatment of primary hypertension? A meta-analysis. Lancet. 2005 Oct 29-Nov 4;366(9496):1545-53. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16257341
    Beevers DG. The end of beta blockers for uncomplicated hypertension? Lancet. 2005 Oct 29-Nov 4;366(9496):1510-2. No abstract available. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16257329
  10. Khan N and McAlister FA, Re-examining the efficacy of beta blockers for treatment of hypertension. A meta-analysis. CMAJ 2006; 174:1737 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16754904
  11. Prescriber's Letter 14(8): 2007 CHART: AHA Blood Pressure Goals and Treatments Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=230801&pb=PRL (subscription needed) http://www.prescribersletter.com
  12. 12.0 12.1 12.2 Bangalore S et sl, Relation of beta-blocker-induced heart rate lowering and cardioprotection in hypertension. J Am Coll Cardiol 2008 52:1482 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19017516
    Kaplan NM Beta-blockers in hypertension: Adding insult to injury. J Am Coll Cardiol 2008 52:1490 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19017517
  13. Prescriber's Letter 14(8): 2007 Comparison of Oral Beta-Blockers Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=250302&pb=PRL (subscription needed) http://www.prescribersletter.com
  14. 14.0 14.1 Bangalore S et al. for the REACH Registry Investigators. beta-blocker use and clinical outcomes in stable outpatients with and without coronary artery disease. JAMA 2012 Oct 3; 308:1340. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23032550
  15. Prescriber's Letter 19(12): 2012 CHART: Comparison of Oral Beta-Blockers Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=281221&pb=PRL (subscription needed) http://www.prescribersletter.com
  16. 16.0 16.1 16.2 Deprecated Reference
  17. 17.0 17.1 Boyles S No Fetal Heart Risk from Mom's Beta-Blocker Use - More complete data point finger at maternal confounders. MedPage Today. April 18, 2017
    Duan L, Ng A, Chen W et al beta-Blocker exposure in pregnancy and risk of fetal cardiac anomalies. JAMA Intern Med. 2017 Apr 17 PMID: https://www.ncbi.nlm.nih.gov/pubmed/28418448
  18. 18.0 18.1 Valdes AM, Abhishek A, Muir K et al Association of Beta-Blocker Use With Less Prevalent Joint Pain and Lower Opioid Requirement in People With Osteoarthritis. Arthritis Care Res (Hoboken). 2017 Jul;69(7):1076-1081. PMID: https://www.ncbi.nlm.nih.gov/pubmed/27696728
  19. 19.0 19.1 Bateman BT, Heide-Jorgensen U, Einarsdottir K et al beta-Blocker Use in Pregnancy and the Risk for Congenital Malformations: An International Cohort Study. Ann Intern Med. 2018. Oct 16. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/30326014 <Internet> http://annals.org/aim/article-abstract/2707333/blocker-use-pregnancy-risk-congenital-malformations-international-cohort-study
    Ray JG To beta of Not to beta? Very likely K to beta. Ann Intern Med. 2018. Oct 16. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/30326080 <Internet> http://annals.org/aim/article-abstract/2707335/very-likely-ok
  20. 20.0 20.1 Riemer TG, Villagomez Fuentes LE, Algharably EAE et al Do beta-Blockers Cause Depression? Hypertension. 2021. March 15 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33719510 https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.16590
  21. DeWitt CR, Waksman JC. Pharmacology, pathophysiology and management of calcium channel blocker and beta-blocker toxicity. Toxicol Rev 2004; 23:223 PMID: https://www.ncbi.nlm.nih.gov/pubmed/15898828