Classifications Generic Name

Classification: Beta Blockers (nonselective and selective) Generic Name: Nonselective: Carteolol Carvedilol Labetalol Nadolol Penbutolol Pindolol Propanolol Timolol Selective: Acebutolol Atenolol Betaxolol Bisoprolol Metaprolol Nebivolol

Mechanism of Action
Beta blockers compete with adrenergic (sympathetic) neurotransmitters (epinephrine and norepinephrine) for adrenergic receptor sites. Beta1 adrenergic receptor sites are located chiefly in the heart where stimulation results in increased heart rate, contractility, and AV conduction. Stimulation of beta2 adrenergic receptor produces vasodilatin, bronchodilation, and uterine relaxation. Blockade of these receptors antagonizes the effect of neurotransmitter. Beta1 blockers may be relatively selective for beta adrenergic receptorsor non selective blocking both beta1 and beta2 adrenergic receptors.

Indication

Contraindicati on

Adverse Reaction

Nursing Responsiblities

y
CNS: fatigue,weakness, anxiey, depression, dizziness, drowsiness, Insomnia, memory loss, mental status changes, nightmares, EENT: Blurred vision, dry eyes, nasal stuffiness, Resp.: Brochospasm, wheezing, CV: bradycardia, CHF, Pulmonary edema, orthostatic hypotension, peripheral vasoconstriction. GI: Constipation, diarrhea, nausea GU: Erectile dysfunction, decreased libido, DERM: Itching, rashes Endo: Hyperglycemia,hypogly cemia

Management of hypertension, angina pectoris, tachyarrythmias, hypertrophic, subaortic stenosis, migraine headache, (prophylaxis), MI (prevention), Glaucoma (ophthalmic use), CHF(carvedinol and sustained release metoprolol only)and hyperthyroidism ( management of symptoms only).

Uncompensate d CHF (mostbeta blockers), acute brochospasm, some form of valvular heart disease, bradyarrythmia s, and heart block.

Monitor blood pressure and pulse frequently during dosage adjustment and periodically throughout therapy. Monitor intake and output ratios and daily weight. Assess patient routinely for signs and symptoms of CHF (dyspnea, rales/crackles, weight gain, peripheral edema, jugular venous distention). Angina: assess frequency and severity of episodes of chest pain periodically throughout therapy. Migraine prophylaxis: assess frequency and severity of migraine headaches periodically throughout therapy. Take apical pulse prior to administering. If HR is <50 bpm or if arrhythmias occur, hold medication and notify health care professionals. Instruct patient to continue taking medication, even if feeling well.