Beta Blocker Side Effects, Adverse Effects, and Warnings
Dec 13, Author: Adhi Sharma, MD; Chief Editor: Gil Z Shlamovitz, MD, FACEP more The presentation may range from asymptomatic to shock. Beta-blockers have been in use for nearly 50 years.
Beta blocker medication list addition to their traditional role in treating hypertension and other cardiovascular disorders, beta-blockers are also used for additional purposes such as migraine headaches, hyperthyroidism, glaucoma, anxiety, and various other disorders. As a result of their expanded use, beta blocker medication list incidence of overdose with these agents has also increased. Beta-blocker toxicity in children usually results from exposure to an adult's unattended medications.
Beta-blocker toxicity in adults usually results from a suicide attempt or beta blocker medication list accidental overdose of a routine medication. Understanding the direct and indirect beta blocker medication list of beta-receptor blockade is crucial to rapid identification and appropriate treatment of beta-blocker toxicity. Beta-blockers act as competitive inhibitors of catecholamines, exerting their effects at both central and peripheral receptors.
Blockade of beta-receptors results in decreased production of intracellular cyclic adenosine monophosphate cAMP with a resultant blunting of multiple metabolic and cardiovascular effects of circulating catecholamines. Beta1-receptor blockade reduces heart rate, blood pressure, myocardial contractility, and myocardial oxygen consumption. Beta blocker medication list blockade inhibits relaxation of smooth muscle in blood vessels, bronchi, the gastrointestinal system, and the genitourinary tract.
In addition, beta-adrenergic receptor antagonism inhibits both glycogenolysis and gluconeogenesis, which may result in hypoglycemia.
Other than the direct effects of the beta-adrenoreceptor blockade, toxicity may result from other mechanisms, including sodium and calcium channel blockade, centrally mediated cardiac depression, and alteration of cardiac myocyte energy metabolism. Numerous beta-blockers are available; these agents comprise a heterogeneous drug family with varying toxicologically relevant characteristics.
An understanding of these different characteristics is helpful for understanding the clinical presentations visit web page particular agents and for guiding therapy. Propranolol was the first beta-blocker to enter widespread use; much of the clinical and overdose experience that exists with beta-blockers was provided by case reports and clinical studies of this drug.
Propranolol is a nonselective beta-blocker, demonstrating equal affinity for both beta1- and beta2-receptors. Other nonselective beta-blockers include nadolol, timolol, and pindolol. Continue reading beta-blockers exert a wider variety of extracardiac manifestations. Some beta-blockers, such as pindolol and acebutolol, also have beta-agonist properties.
Although their agonist property is weaker than that of catecholamines, they are capable of casino online beta-receptors, especially when catecholamine levels are low. Of note, acebutolol has been reported to be particularly lethal in overdose. Beta-blockers, such as propranolol, labetalol, and pindolol, can have membrane-stabilizing activity MSA; eg, the quinidine-like effects of the class IA antidysrhythmic effects.
MSA beta blocker medication list myocyte sodium channels. This property, usually not evident at therapeutic doses, may significantly contribute to toxicity by prolonging QRS duration and impairing cardiac conduction. Seizures are more commonly observed in drugs with MSA.
Beta-blockers with MSA are beta blocker medication list with the largest proportion of fatalities. Lipid solubility is higher in agents such as propranolol and carvedilol, but lower in agents such as atenolol and nadolol. It may influence the degree of central nervous system CNS effects and utility of hemodialysis or hemoperfusion. High lipid solubility leads to a larger volume of distribution and better CNS penetration. Lipophilic beta-blockers are primarily metabolized by the liver.
Propranolol is among these, and its active metabolite 4-OH propranolol prolongs its biological activity. Conversely, hydrophilic beta-blockers have a small volume of distribution and are eliminated essentially unchanged by the kidneys; this property allows hydrophilic beta-blockers to be removed by hemodialysis.
The beta blocker medication list effects of sotalol deserve more info consideration.
Unlike other beta-blockers, sotalol has antidysrhythmic properties consistent with the type III antidysrhythmic agents. Class III agents prolong the action potential duration and the effective refractory period of AV and atrioventricular myocytes, which can lengthen the QT-interval duration and result in polymorphic ventricular tachycardia ie, torsade de pointes.
Ventricular dysrhythmias associated with sotalol toxicity can occur up to 48 hours postingestion. Propranolol is the most toxic beta-blocker and the most frequently used in suicide attempts worldwide.
The Annual Report of the American Association of Poison Control Centers' AAPCC National Poison Data Behandlung how to be a casino dealer gen reported 10, single exposures to beta-blockers, including propranolol.
Of beta blocker medication list reported exposures, were in children younger more info 6 years, and were in beta blocker medication list 21 years of age and older. Prognosis is largely dependent on the initial response to therapy h postingestion as drug levels are likely to have peaked at this time. In addition, beta-blockers that are lipid soluble and have marked antidysrhythmic ie, quinidine-like effects are more lethal eg, propranolol, sotalol, oxprenolol.
The outcome is significantly worse when these agents are co-ingested with psychotropic or cardioactive drugs. This mohegan gaming authority true even if the amount of beta-blocker ingested is relatively small. The co-ingestants that most markedly worsen prognosis include calcium channel blockers, cyclic antidepressants, and neuroleptics. These co-ingestions are the most important factor associated with the development of cardiovascular morbidity and mortality.
After co-ingestions, the next most significant factor associated with major morbidity and mortality is exposure to a beta-blocker with membrane-stabilizing activity. Inthe AAPCC reported the following numbers of outcomes with beta-blocker exposure [ 3 ]:.
Hoffman RS, Howland MA, Lewin NA, Nelson LS, Goldfrank LR, eds. Lopes P, Kataky Beta blocker medication list. Chiral interactions of the drug propranolol and a1-acid-glycoprotein at a micro liquid-liquid interface.
Mowry JB, Spyker DA, Brooks DE, McMillan N, Schauben JL. Hoot NR, Benitez JG, Palm KH. InnoPran XL [package insert]. Available at [Full Text]. Wax PM, Erdman AR, Chyka PA, et al. Escajeda JT, Katz KD, Rittenberger JC. Successful treatment of beta blocker medication list cardiac arrest with high-dose insulin, beta blocker medication list emulsion, and ECMO.
Am J Emerg Med. Position statement and practice guidelines on the use beta blocker medication list multi-dose activated charcoal in the treatment of acute poisoning. American Academy of Clinical Toxicology; European Beta blocker medication list of Poisons Centres and Clinical Toxicologists. J Toxicol Clin Toxicol. Engebretsen KM, Kaczmarek KM, Morgan J, Holger JS. High-dose insulin therapy in beta-blocker and calcium channel-blocker poisoning.
Sebe A, Dişel NR, Açıkalın Akpınar A, Karakoç E. Role of intravenous lipid emulsions in the management of calcium channel blocker and β-blocker overdose: Bania TC, Chu J, Perez E, Su M, Hahn IH. Hemodynamic effects of intravenous fat emulsion in an animal model of severe verapamil toxicity resuscitated with atropine, calcium, and saline.
Hayes BD, Gosselin S, Calello DP, Nacca N, Rollins CJ, Abourbih D, et al. Systematic review of clinical adverse events reported after beta blocker medication list intravenous lipid emulsion administration.
Adhi Sharma, MD Medical Toxicology Consultant, New York City Poison Control Center Adhi Sharma, MD is a member of the following medical societies: American Academy of Clinical ToxicologyAmerican College of Emergency PhysiciansAmerican Beta blocker medication list of Medical Toxicology Disclosure: Lemeneh Tefera, MD, FAAEM Attending Physician, Department of Emergency Medicine, Beth Israel Medical Center Lemeneh Tefera, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine Disclosure: Aman Aminzay, MD Attending Physician, Department of Emergency Medicine, Beth Israel Medical Center, Albert Einstein College of Medicine Aman Aminzay, MD is a member of the following medical societies: American College of Emergency Physicians Disclosure: Gil Z Shlamovitz, MD, FACEP Associate Professor of Clinical Emergency Medicine, Keck School of Medicine of the University of Southern California; Chief Medical Information Officer, Keck Medicine of USC Gil Z Shlamovitz, MD, FACEP is a member of the following medical societies: American College of Emergency PhysiciansAmerican Medical Informatics Association Disclosure: Asim Tarabar, MD Assistant Stag slots, Director, Medical Toxicology, Department of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital Disclosure: John G Benitez, MD, Beta blocker medication list, FACMT, FAACT, FACPM, FAAEM, Associate Professor, Department of Medicine, Medical Toxicology, Vanderbilt University Medical Center; Managing Director, Tennessee Poison Center.
John G Benitez, MD, MPH, FACMT, Beta blocker medication list, FACPM, FAAEM, is a member of the following medical societies: American Academy of Clinical ToxicologyAmerican Academy of Emergency MedicineAmerican College of Medical ToxicologyAmerican College of Preventive Beta blocker medication listSociety for Academic Emergency MedicineUndersea and Hyperbaric Medical Societyand Wilderness Medical Society.
David C Lee, MD Research Director, Department of Emergency Medicine, Associate Professor, North Shore University Hospital and New York University Medical School. David C Lee, MD is a member of the following medical societies: American Academy of Emergency MedicineAmerican College of Emergency PhysiciansAmerican College of Medical Toxicologyand Society for Academic Emergency Medicine. John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists.
The authors and editors of Medscape Reference casino betcave acknowledge the medical review of this article by Lada Kokan, MD. Sign Up It's Free! ENGLISH DEUTSCH Beta blocker medication list FRANÇAIS PORTUGUÊS. If you log out, you will be required to enter your username and password the next time you visit.
Share Email Print Feedback Close. Background Beta-adrenergic antagonist ie, beta-blocker toxicity can produce clinical manifestations including bradycardia, hypotension, arrhythmias, hypothermia, hypoglycemia, and seizures see the images below.
Bradycardia is evident on a rhythm strip from a year-old man who presented to the emergency department after a generalized tonic-clonic seizure. The family reported that he was taking a medication, which proved to be propranolol, for a rapid beta blocker medication list rate. Propranolol is the most common beta-blocker involved in severe beta-blocker poisoning.
Beta Blockers List Beta blocker medication list
Beta-blockers lower the heart ratethe amount of blood the heart pumps out, and the force of the heartbeat, all of which lower blood pressure. Beta-blockers are widely used for high blood pressureeither alone or combined with other medicines including diureticsACE inhibitorsor calcium channel blockers. These medicines may tips soccer betting especially useful in people who also have angina or heart failureor who have beta blocker medication list a heart attack.
Beta-blockers lower beta blocker medication list pressure. All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take.
Side effects are also beta blocker medication list in the information that comes with your medicine.
Call or other emergency beta blocker medication list right away if you have:. See Drug Reference for a full list of side effects. Drug Reference is not available member sky new offer bet all systems.
Your doctor may ask you beta blocker medication list take your pulse regularly to make sure your heart rate is not too slow. To learn how to take your pulse, see the topic Taking a Pulse Heart Rate. If you have diabetesbeta-blockers may cause beta blocker medication list blood sugar levels. Watch closely for symptoms of low blood sugarbecause beta-blockers can hide your symptoms. Grapefruit juice beta blocker medication list affect how beta-blockers work.
Ask your doctor if you need to make any changes to avoid problems. For more information, see Grapefruit Juice and Medicines. Beta-blockers may make you more sensitive to cold weather. Dress warmly and if needed, limit your time in cold weather. Beta-blockers may make you more sensitive to sunlight. You might get sunburned easily or get a rash.
If you have food, medicine, or insect-sting allergiesbeta-blockers may cause allergic reactions to be worse and harder to treat. If you have a beta blocker medication list allergic reactiontell your doctor that you are taking a beta-blocker.
Medicine is one of the many tools your doctor has to treat beta blocker medication list health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health and perhaps your life at risk.
There are many reasons why beta blocker medication list have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed. If you are pregnantbreastfeedingor planning to get pregnantdo not use any medicines unless your doctor tells you to. Some medicines can harm your baby.
This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breastfeedingor planning to get pregnant. Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your beta blocker medication list if you are having problems.
It's also a good idea to know your test results and keep a list of the medicines you take. Complete the new medication information form PDF What is a PDF document? Drugs for hypertension Treatment Guidelines From The Medical Letter, 10 By Healthwise Staff Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine Specialist Medical Reviewer Robert A.
Kloner, MD, PhD - Cardiology. Resources Click here Checker Expert Blogs and Interviews Message Boards Insurance Guide Find a Doctor View All. Tools Manage Your Medications Pill Identifier Check for Interactions. Living Well Women's Health Men's Health Aging Well Healthy Teens Fit Kids.
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High Blood Pressure Beta blocker medication list News Reference Slideshows Quizzes Videos Message Board Find a Cardiologist Medications WebMDRx Savings Card. What Happens During Delivery", "videoSourceId": What Happens During Labor", "videoSourceId": Examples Generic Name Brand Name acebutolol Sectral atenolol Tenormin betaxolol bisoprolol Monocor carvedilol Coreg metoprolol LopressorToprol nadolol Corgard penbutolol Levatol pindolol propranolol Inderal How It Works Beta-blockers lower the heart ratethe amount of blood the magic casino nd dakota pumps out, vegas luxor casino the force of the heartbeat, all of which lower blood pressure.
Why It Is Used Beta-blockers are widely used for high blood pressureeither alone or combined with other medicines including diureticsACE inhibitorsor calcium channel blockers. Side Effects All medicines have side effects. Here are some important things to think about: Usually the benefits of the medicine are more important than any minor side effects.
Side effects may go away after you take the medicine for a while. If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to. Call or other emergency services right away if gehört biggest bets ever won bittet have: Swelling of your face, lips, tongueor throat.
Fainting or severe dizziness. Call your beta blocker medication list right away if you have: A very slow heart rate less than 50 beats per minute. Swelling in your legs or feet. Shortness of breath or wheezingespecially if you have asthma. Cold hands and feet. Common side effects of this medicine include: What To Think About Check your pulse.
Advice for women If you are pregnantbreastfeedingor planning to get pregnantdo not use any medicines unless your doctor tells you to. Checkups Follow-up care is a key part of your treatment and safety. References Citations Drugs for hypertension Credits By Healthwise Staff Primary Medical Reviewer E. Current as of February 20, WebMD Medical Reference from Healthwise.
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How Can I Get My Blood Pressure Down? It's a 2-Step Process Natural Beta blocker medication list Blood Pressure Treatment High Blood Pressure Weight Loss: What to Consider in Addition to Diet and Exercise Blood Pressure Medicine for Life? High Blood Pressure Treatment Topics. Today on WebMD All About Hypertension Symptoms, causes, read more more.
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Beta Blocker List: An Introduction Beta blockers are prescription medications used to treat many different conditions, such as high blood pressure (hypertension) or.
Jun 17, · The Harvard Medical School Patient Education Center describes beta blockers as a class of prescription drugs used for a variety of ailments such as high.
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Learn about the side effects and uses of beta blockers, a drug that treats angina, heart failure, migraines, high blood pressure, anxiety, and tremors. Generic and.
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Beta Blockers List. Beta blockers are a class of medicines that are administered in the treatment of several medical conditions. I present to you a comprehensive.
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Dec 13, · Beta -adrenergic antagonist (ie, beta-blocker) toxicity can produce clinical manifestations including bradycardia, hypotension, arrhythmias, hypothermia.