Beta Blockers Nursing Pharmacology Show
Beta-adrenergic blocking agents, commonly known as beta blockers, are medications used to reduce blood pressure and are often prescribed to treat cardiac problems. They work by blocking the effects of adrenaline, also called epinephrine, which is “the fight or flight” hormone. Beta blockers may affect the heart and blood vessels. They reduce the blood pressure by slowing down the heart rate and contractility, as well as by improving blood flow by dilating veins and arteries. Beta blockers provide various clinical benefits but may also pose a risk for adverse effects if not properly monitored. Beta blockers are classified into three categories: non-selective, cardio-selective, and third-generation. They can be administered orally, intravenously, or intramuscular route, they are also available in ophthalmic form. Several factors are taken into consideration prior to prescribing which type of beta blockers will be used for a patient. These factors include the type of condition currently being treated, potential side effects, and other conditions or medications that the patient is already taking. Glucagon is the antidote in case of beta blocker toxicity. Indications for Beta BlockersBeta blockers are used in conjunction with other medications to reduce blood pressure. Although they are used for the treatment of cardiovascular diseases, they are not recommended as first line treatment for hypertension alone and are often prescribed when other medications like diuretics are ineffective. The effectiveness of beta blockers may be affected by age as they may not be as effective for older people, especially when used as a single agent. Beta blockers are indicated for the treatment of arrhythmia because of their ability to slow down the heart rate. They are also used to reduce mortality for patients who have recovered from heart attacks and congestive heart failure. Beta blockers are also indicated to treat symptoms of cardiac-related conditions such as angina, postural tachycardia syndrome, coronary artery disease, portal hypertension, and aortic dissection. They may also be used to treat other conditions such as migraine, glaucoma, and certain types of tremors. Actions of Beta blockersBeta blockers block the effect of beta-adrenergic stimuli of epinephrine and norepinephrine by binding to beta-adrenoceptors that are found in the cardiac nodal tissue and inhibiting their normal sympathetic effects. Beta-adrenoceptors are related to GS-proteins, which increase heart rate and contractility by increasing calcium absorption into the cells. Beta blockers antagonize their effects, preventing the binding of epinephrine and norepinephrine to these receptors. The first-generation beta blockers block both beta-1 and beta-2 receptors, as compared to the second-generation beta blockers, which block only beta-1 adrenoceptors. The third generation of beta blockers blocks alpha-adrenoceptors, thereby producing vasodilation effects. Side Effects and Adverse Reactions of Beta blockersAlthough beta blockers are relatively safe and effective, they can still produce some side effects, just like most medications. Due to the presence of baroreceptors all throughout the body, physiologic side effects can be very broad. The frequent side effects of beta blockers are fatigue, dizziness, poor circulation which is due to low blood pressure that is triggered by a decrease in heart rate. They may also cause gastrointestinal problems such as stomach upset, constipation and diarrhea. Other side effects of taking beta blockers include sexual dysfunction, weight gain, and cold extremities. Beta blockers commonly cause bradycardia and hypotension as a result of their cardiac mechanism. The side effects that are less common include depression, shortness of breath and disturbances in sleeping pattern. The adverse effects of beta blockers may consist of bronchospasm, increased insulin resistance, prolonged QT intervals and an increased risk of heart block. Contraindications and Cautions for Beta BlockersBeta blockers have a US FDA Category of C, and should be used with caution during pregnancy. However, they are effective for treating tachycardia and arrhythmias in mother and fetus. Beta blockers are generally contraindicated in patients with asthma and chronic obstructive pulmonary disease (COPD) because they can cause bronchospasm. They should be avoided in patients with Raynaud’s disease due to the risk of exacerbation. Because beta blockers reduce heart rate and exercise capacity, they are also contraindicated for patients with sinus bradycardia, partial and high degree AV block. It is necessary for people with diabetes to monitor blood sugar levels when taking beta blockers because they can hinder signs of hypoglycemia. These medications may also cause a slight elevation of triglycerides, so it is important to monitor cholesterol and triglycerides levels. Alcohol consumption must be avoided during the course of treatment, because alcohol can lower the blood pressure, increase dizziness, and pose the risk for sudden hypotension. Beta blockers should not be discontinued abruptly as doing so may increase the likelihood of a heart attack and other cardiac problems. Drug Interactions with Beta blockersBeta-blockers can interact with other medications commonly administered, such as antihypertensive drugs, antianginals, insulin and other medications for diabetes, non-steroidal anti-inflammatory drugs (NSAIDs) and certain antibiotics like rifampicin. They may also have an interaction with other drugs such as anesthetics, anti-ulcer medications, antidepressants, anti-lipidemic, decongestants, and medications used to treat asthma, chronic obstructive pulmonary disease and Parkinson’s disease. Nursing Care Plan for Patients on Beta BlockersPossible Beta Blockers Nursing DiagnosisDecreased Cardiac Output related to the mechanism of action of beta blockers Risk for Bowel Incontinence related to side effect of beta blockers Risk for Constipation related to side effect of beta blockers Deficient knowledge related to beta blockers Nursing Assessment
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Beta Blocker Quiz 5 Questions
Nursing ReferencesAckley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. Buy on Amazon Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier. Buy on Amazon Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Buy on Amazon Disclaimer:Please follow your facilities guidelines and policies and procedures. The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment. |