n. a *beta blocker used mainly in the treatment of angina pectoris and *arrhythmias and to prevent migraine attacks. Side-effects include decreased heart rate, dizziness, and low blood pressure.
They work by blocking the stimulation of beta adrenergic receptors by the neurotransmitters adrenaline and noradrenaline, which are produced at the nerve endings of that part of the SYMPATHETIC NERVOUS SYSTEM – the autonomous (involuntary) network
– which facilitates the body’s reaction to anxiety, stress and exercise – the ‘fear and ?ight’ response.
Beta1 blockers reduce the frequency and force of the heartbeat; beta2 blockers prevent vasodilation (increase in the diameter of blood vessels), thus in?uencing the patient’s blood pressure. Beta1 blockers also affect blood pressure, but the mechanism of their action is unclear. They can reduce to normal an abnormally fast heart rate so the power of the heart can be concomitantly controlled: this reduces the oxygen requirements of the heart with an advantageous knock-on e?ect on the respiratory system. These are valuable therapeutic effects in patients with ANGINA or who have had a myocardial infarction (heart attack – see HEART, DISEASES OF), or who suffer from HYPERTENSION. Beta2 blockers reduce tremors in muscles elsewhere in the body which are a feature of anxiety or the result of thyrotoxicosis (an overactive thyroid gland – see under THYROID GLAND, DISEASES OF). Noncardioselective blockers also reduce the abnormal pressure caused by the increase in the ?uid in the eyeball that characterises GLAUCOMA.
Many beta-blocking drugs are now available; minor therapeutic di?erences between them may in?uence the choice of a drug for a particular patient. Among the common drugs are:
| Primarily cardioselective | Non-cardioselective |
| Acebutolol | Labetalol |
| Atenolol | Nadolol |
| Betaxolol | Oxprenolol |
| Celiprolol | Propanolol |
| Metoprolol | Timolol |
These powerful drugs have various side-effects and should be prescribed and monitored with care. In particular, people who suffer from asthma, bronchitis or other respiratory problems may develop breathing diffculties. Long-term treatment with beta blockers should not be suddenly stopped, as this may precipitate a severe recurrence of the patient’s symptoms – including, possibly, a sharp rise in blood pressure. Gradual withdrawal of medication should mitigate untoward effects.... beta-adrenoceptor-blocking drugs
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