Beta Blockers

Beta Blockers

I Available Forms
A. atenolol (Tenormin)
B. metoprolol (Lopressor)
C. propranolol (Inderal)
D. nadolol (Corgard)
II Mechanism of Action
A. decrease hr resulting in decreased myocardial O2 demand and increase O2 delivery to the heart
B. decrease myocardial contractility helps to conserve energy or decrease demand
C. blocks norepinephrine
III Indications
A. angina
B. anti HPN
C. cardioprotective effects, especially after MI
D. some used for migraine headaches
IV Side effects
A. cardiovascular
1. bradycardia
2. hypotension
3. 2nd or 3rd degree heart block
4. heart failure
B. metabolic
1. glucose
2. lipids
C. CNS
1. dizziness
2. fatigue
3. mental depression
4. lethargy
5. drowsiness
6. unusual dreams
D. other
1. impotence
2. wheezing
3. dyspnea w/ non-selective BB
V Nursing implications
A. monitor pulse rate daily and report any rate lower than 60 bpm
B. dizziness or fainting should also be reported
C. constipation is a common problem; instruct pts to take in adequate fluids and eat high fiber foods
D. never abruptly discontinue due to risk of rebound HPN crisis
E. inform pts that these meds are for long term prevention of angina, not immediate relief