drug adverse effects of beta-adrenergic receptor antagonists
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Adverse effects
- bronchospasm
- bradycardia
- decreased cardiac output
- negative inotropic effects
- abrupt withdrawal may precipitate arrhythmia or angina
- may mask symptoms of hypoglycemia
- non-selective beta blockers can inhibit glucose release & increase sensitivity to insulin by impairing adrenergic response
- effect is uncommon & usually mild[13]
- non-selective beta blockers can inhibit glucose release & increase sensitivity to insulin by impairing adrenergic response
- unopposed alpha adrenergic activity may potentiate coronary artery vasospasm, peripheral arterial vasospasm
- lethargy
- confusion & diminished ability to concentrate
- impotence
- potentiation of Raynaud's phenomenon
- nightmares
- insomnia
- depression is[2], but is not[1][11], & might be[3] an adverse effect of beta-blockers
- may diminish effect of sulfonylureas
- hyperkalemia (extracellular shift of K+)
- metabolic alkalosis
- increased triglycerides
- diminished HDL cholesterol
- may exacerbate psoriasis[4]
- may increase risk of developing diabetes mellitus[5]
- NO ADVANTAGE IN PREVENTING MYOCARDIAL INFARCTION OR DEATH WHEN USED TO TREAT HYPERTENSION[6]
- beta-blocker-associated reduction in heart rate increases risk of cardiovascular events & death in hypertensive patients[7]
- increases risk of stroke in elderly patients[8]
- no fetal heart risk from Mom's beta-blocker usage[9]
- xerosis resulting in pruritus []
- supportive therapy:
- IV access
- continuous cardiac monitoring
- bradycardia
- atropine generally not useful (not vagally mediated)
- glucagon 2-4 mg IV over 1-2 minutes, then start infusion at 2-5 mg/hr (do not exceed 10 mg/hr);
- may cause nausea/vomiting
- monitor for vagally-mediated bradycardia
- ventricular pacing
- hypotension
- calcium gluconate 3-9 g IV through peripheral line
- calcium chloride 1-2 g IV over 10 minutes through a central venous catheter is alternative (caution: sclerosing agent)
- high-dose insulin euglycemia therapy
- intra-aortic balloon pump
More general terms
References
- ↑ 1.0 1.1 Medical Knowledge Self Assessment Program (MKSAP) 11, 15, American College of Physicians, Philadelphia 1998
- ↑ 2.0 2.1 Manual of Medical Therapeutics, 28th ed, Ewald & McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 158-59
- ↑ 3.0 3.1 Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 474-75, 491
- ↑ 4.0 4.1 The Washington Manual of Medical Therapeutics, 33rd edition Foster C et al (eds) Lippincott, Williams & Wilkins, Philadelphia, 2010, pg 969
- ↑ 5.0 5.1 Journal Watch 20(9): 72, 2000 Gress TW et al Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. Atherosclerosis Risk in Communities Study. N Engl J Med 342:905, 2000 PMID: https://www.ncbi.nlm.nih.gov/pubmed/10738048
- ↑ 6.0 6.1 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 - ↑ 7.0 7.1 Bangalore S et al Relation of Beta-Blocker Induced Heart Rate Lowering and Cardioprotection in Hypertension J Am Coll Cardiol. 2008; 52:1482-1489 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19017516
- ↑ 8.0 8.1 Bangalore S et al. Beta-blockers for primary prevention of heart failure in patients with hypertension: Insights from a meta-analysis. J Am Coll Cardiol 2008 Sep 23; 52:1062. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18848139
- ↑ 9.0 9.1 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 - ↑ Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019
- ↑ 11.0 11.1 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
- ↑ 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
- ↑ 13.0 13.1 NEJM Knowledge+