Formulary recommendations for an MAPD plan, based on the evaluation of its clinical benefits & possible
place in therapy amongst other beta blockers
This document discusses hypertension, also known as the "Dajal of the 21st century". It provides an overview of cardiovascular risks associated with increases in blood pressure. It then discusses approaches for managing hypertension, including lifestyle modifications and medical therapy. Specific antihypertensive drugs discussed include ACE inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers, and thiazide diuretics. Nebivolol, a beta blocker with nitric oxide mediated vasodilation properties, is highlighted for its ability to improve endothelial function compared to other beta blockers.
The document summarizes recent advances in understanding the endothelium and nitric oxide, with a focus on the beta blocker nebivolol. Nebivolol is a highly selective beta-1 receptor blocker that also stimulates nitric oxide production, giving it vasodilatory effects. Unlike other beta blockers, nebivolol has been shown to improve endothelial function, exercise capacity, and left ventricular function in heart failure and hypertension without impairing glucose or lipid metabolism.
Strategies for the use of cardioselective beta blockers in cv continuum scsinha
This document summarizes strategies for using cardioselective beta blockers in the cardiovascular continuum. It discusses the sympathetic nervous system and classifications of beta blockers. The key beta blockers of bisoprolol, atenolol, carvedilol, metoprolol, and nebivolol are compared in indications, characteristics, and therapeutic effectiveness for hypertension, coronary artery disease, post-myocardial infarction, and heart failure based on clinical studies. Overall, the beta blockers show similar efficacy but some differences are seen in subsets of patients or conditions.
This document summarizes research on Nebivolol, a novel beta-blocker with nitric oxide-induced vasodilating properties. Key points:
- Nebivolol is a beta-1 selective blocker that also facilitates nitric oxide release, causing vasodilation. This is unique among beta-blockers.
- Clinical trials show Nebivolol is as effective at lowering blood pressure as other beta-blockers, ACE inhibitors, and calcium channel blockers.
- Nebivolol has a side effect profile similar to placebo, with fewer reports of fatigue and sexual dysfunction compared to other beta-blockers.
1) Beta blockers are commonly used to treat cardiovascular diseases like hypertension and heart failure. They are classified based on selectivity for beta-1 receptors and generation.
2) Beta blockers lower blood pressure and heart rate, reducing myocardial oxygen demand. They protect against arrhythmias and apoptosis. In heart failure, they improve beta receptor signaling and calcium handling.
3) Clinical trials show beta blockers reduce mortality when used for acute treatment, secondary prevention, and in patients with diabetes and coronary artery disease. They are recommended for hypertension in patients with concomitant coronary disease.
1) Beta blockers are recommended in current cardiovascular guidelines for the treatment of hypertension and heart failure.
2) Studies have shown that lowering blood pressure, including through the use of beta blockers, reduces complications from diabetes such as heart attacks, strokes, and heart failure.
3) Different beta blockers have varying selectivity for beta-1 receptors in the heart versus beta-2 receptors elsewhere. Some beta blockers also have additional alpha-blocking or vasodilating properties.
This document discusses beta-blockers, including their discovery, mechanism of action, uses, side effects, and current research. Beta-blockers were discovered in 1962 and work by blocking beta-1 and beta-2 adrenoceptors. They are used to treat various cardiovascular conditions like hypertension, angina, and arrhythmias. While generally effective, they can cause side effects like bradycardia, bronchospasm, and hypoglycemia. Current research is exploring their potential roles in cancer treatment and fracture prevention.
Betazok in hf_cm_eslides_21jun2010 full slidesbevsjocson
This document summarizes the advantages of metoprolol succinate in treating heart failure. It discusses how metoprolol succinate has zero-order kinetics, allowing for once daily dosing. The MERIT-HF trial found that metoprolol succinate reduced total mortality by 34% compared to placebo in heart failure patients. It also reduced sudden death by 41% and death from worsening heart failure by 49%. Metoprolol succinate provides significant clinical benefits for heart failure patients.
This document discusses hypertension, also known as the "Dajal of the 21st century". It provides an overview of cardiovascular risks associated with increases in blood pressure. It then discusses approaches for managing hypertension, including lifestyle modifications and medical therapy. Specific antihypertensive drugs discussed include ACE inhibitors, angiotensin receptor blockers, beta blockers, calcium channel blockers, and thiazide diuretics. Nebivolol, a beta blocker with nitric oxide mediated vasodilation properties, is highlighted for its ability to improve endothelial function compared to other beta blockers.
The document summarizes recent advances in understanding the endothelium and nitric oxide, with a focus on the beta blocker nebivolol. Nebivolol is a highly selective beta-1 receptor blocker that also stimulates nitric oxide production, giving it vasodilatory effects. Unlike other beta blockers, nebivolol has been shown to improve endothelial function, exercise capacity, and left ventricular function in heart failure and hypertension without impairing glucose or lipid metabolism.
Strategies for the use of cardioselective beta blockers in cv continuum scsinha
This document summarizes strategies for using cardioselective beta blockers in the cardiovascular continuum. It discusses the sympathetic nervous system and classifications of beta blockers. The key beta blockers of bisoprolol, atenolol, carvedilol, metoprolol, and nebivolol are compared in indications, characteristics, and therapeutic effectiveness for hypertension, coronary artery disease, post-myocardial infarction, and heart failure based on clinical studies. Overall, the beta blockers show similar efficacy but some differences are seen in subsets of patients or conditions.
This document summarizes research on Nebivolol, a novel beta-blocker with nitric oxide-induced vasodilating properties. Key points:
- Nebivolol is a beta-1 selective blocker that also facilitates nitric oxide release, causing vasodilation. This is unique among beta-blockers.
- Clinical trials show Nebivolol is as effective at lowering blood pressure as other beta-blockers, ACE inhibitors, and calcium channel blockers.
- Nebivolol has a side effect profile similar to placebo, with fewer reports of fatigue and sexual dysfunction compared to other beta-blockers.
1) Beta blockers are commonly used to treat cardiovascular diseases like hypertension and heart failure. They are classified based on selectivity for beta-1 receptors and generation.
2) Beta blockers lower blood pressure and heart rate, reducing myocardial oxygen demand. They protect against arrhythmias and apoptosis. In heart failure, they improve beta receptor signaling and calcium handling.
3) Clinical trials show beta blockers reduce mortality when used for acute treatment, secondary prevention, and in patients with diabetes and coronary artery disease. They are recommended for hypertension in patients with concomitant coronary disease.
1) Beta blockers are recommended in current cardiovascular guidelines for the treatment of hypertension and heart failure.
2) Studies have shown that lowering blood pressure, including through the use of beta blockers, reduces complications from diabetes such as heart attacks, strokes, and heart failure.
3) Different beta blockers have varying selectivity for beta-1 receptors in the heart versus beta-2 receptors elsewhere. Some beta blockers also have additional alpha-blocking or vasodilating properties.
This document discusses beta-blockers, including their discovery, mechanism of action, uses, side effects, and current research. Beta-blockers were discovered in 1962 and work by blocking beta-1 and beta-2 adrenoceptors. They are used to treat various cardiovascular conditions like hypertension, angina, and arrhythmias. While generally effective, they can cause side effects like bradycardia, bronchospasm, and hypoglycemia. Current research is exploring their potential roles in cancer treatment and fracture prevention.
Betazok in hf_cm_eslides_21jun2010 full slidesbevsjocson
This document summarizes the advantages of metoprolol succinate in treating heart failure. It discusses how metoprolol succinate has zero-order kinetics, allowing for once daily dosing. The MERIT-HF trial found that metoprolol succinate reduced total mortality by 34% compared to placebo in heart failure patients. It also reduced sudden death by 41% and death from worsening heart failure by 49%. Metoprolol succinate provides significant clinical benefits for heart failure patients.
This document provides information about the beta blocker Betabis (Bisoprolol hemifumarate USP) including its composition, indications, dosage, side effects and positioning compared to other beta blockers. Betabis is a highly selective beta-1 blocker that effectively controls high blood pressure and angina. It shows no impact on lipid or blood glucose levels, making it safer for diabetes patients compared to non-selective beta blockers.
Dr. Onn Akbar Ali is a cardiologist who has moved his practice from Australia to Malaysia. He was previously a consultant cardiologist at the Queen Elizabeth and Lyell McEwin Hospitals in Australia. As of August 2013, he has been practicing at the KPJ Kajang Specialist Hospital in Malaysia. The document provides his contact information and updates that he has relocated his practice.
Role of beta blockers in the management of cardiovascular diseasesPHAM HUU THAI
Beta-blockers play an important role in the management of cardiovascular diseases by reducing sympathetic nervous system activation, balancing myocardial oxygen supply and demand, increasing the threshold for ventricular fibrillation during ischemia, and reducing myocardial oxygen consumption. They are indicated for hypertension, ischemic heart disease, arrhythmias, congestive heart failure, and other conditions. Studies show beta-blockers reduce mortality and cardiovascular events in heart failure and post-myocardial infarction more than other drug classes.
Beta blockers such as atenolol have been shown to have a relatively weak effect in reducing stroke compared to other antihypertensive classes such as calcium channel blockers, ACE inhibitors, and thiazide diuretics. Evidence from Cochrane reviews shows that beta blockers do not reduce the risk of coronary heart disease compared to placebo or no treatment, and they may increase the risk of all-cause mortality and total cardiovascular disease compared to calcium channel blockers. While beta blockers lower the risk of total cardiovascular disease compared to placebo primarily by reducing stroke risk, their effect on other outcomes is not better than other classes of antihypertensive medications.
Beta Blockers in current cardiovascular practice Praveen Nagula
betablockers are the drug of choice for prevention of progression of heart failure with mortality benefit, after the evolution of neurohormonal regulation as pathogenesis of heart failure
This document discusses beta-blockers, which are recommended for treating hypertension, angina, and myocardial infarction. Beta-blockers reduce mortality when used acutely and long-term after myocardial infarction. They are as effective for older patients, reducing mortality by 40%. Common side effects include dizziness, fatigue, and hypotension. Beta-blockers work by blocking beta receptors and lowering the cardiac workload and renin release. They should be initiated within days of a myocardial infarction and continued for up to three years.
The REACH Registry study found that beta-blockers do not reduce the risk of cardiovascular events like death, heart attack, or stroke in stable outpatients with or without coronary artery disease. However, beta-blockers were found to lower the risk of secondary outcomes in patients who had a heart attack within the past year. The study followed over 45,000 patients for 4 years on average and compared outcomes in patients taking beta-blockers to those not taking them.
The document summarizes evidence from randomized controlled trials on the use of beta blockers in patients with acute myocardial infarction (AMI). It discusses several landmark trials from the pre-reperfusion, thrombolysis, and primary PCI eras that demonstrated the benefits of early beta blocker initiation in reducing infarct size, ventricular arrhythmias, cardiogenic shock, and mortality following AMI. The COMMIT trial specifically showed that metoprolol reduces reinfarction rates, arrhythmic death, and cardiogenic shock, especially in higher risk Killip class patients.
ABSTRACT
Carvedilol is a cardiovascular drug of multifaceted therapeutic potential, with beta-blocker and vasodilatative activity. These actions confer to the above mentioned beta blocker some beneficial properties on several processes involving cardiovascular system. Carvedilol provides hemodynamic, ant ischemic, anti-proliferative and antiarrhytmic benefits, for its antioxidant neuro humoral and electrophysiological effects. All these actions provide the basis for usefulness of the drug in the treatment of hypertension, coronary heart disease, and congestive heart failure. In this review we report the beneficial properties of Carvedilol and we analyze the rational clinical use of this beta blocker taking special attention on recent clinical trial in heart failure where it appears evidence supporting an important, favorable effect of the drug.
KEYWORDS: Carvedilol, Hypertension, Coronary disease, Hearth failure.
Beta blockers were first developed in 1962 and are proven to decrease cardiovascular morbidity and mortality. They are the cornerstone therapy for systolic heart failure, significantly reducing mortality and hospitalizations. Beta blockers also significantly reduce mortality in acute myocardial infarction and post-MI, lowering the risk of death by up to 40%. They are effective for preventing sudden cardiac death through various mechanisms including reducing heart rate and oxygen demand.
Beta-blockers were developed by Sir James Black in the 20th century and are considered one of the most important medical advances. They are commonly used to treat cardiovascular conditions like hypertension, angina, heart failure, and arrhythmias. Beta-blockers work by blocking beta-adrenergic receptors in the heart and vessels. They have various beneficial effects including reducing heart rate, blood pressure, myocardial oxygen demand, and the risk of arrhythmias. Larger clinical trials demonstrated improved outcomes with beta-blockers in conditions like heart attack and heart failure.
The success of neurohormonal blockade: looking back – looking forward: Beta-b...drucsamal
- The document summarizes the history of beta-blocker treatment for heart failure, from early studies in the 1970s showing potential benefits to large randomized controlled trials in the 1990s and 2000s firmly establishing mortality reduction.
- Key trials included MDC (1993) showing reduced mortality and heart transplantation, CIBIS-II (1999) showing reduced mortality with bisoprolol, MERIT-HF (1999) showing reduced mortality with metoprolol CR/XL, and COPERNICUS (2001) showing reduced mortality, hospitalizations, and worsening heart failure with carvedilol.
- Meta-analyses demonstrated a consistent mortality reduction of approximately 35% associated with beta-blocker use in
1) The study examined the influence of continuing or withdrawing beta-blocker therapy on outcomes in patients hospitalized with heart failure.
2) It found that continuing beta-blocker therapy was associated with lower risks while withdrawing therapy was linked to excess mortality.
3) Continuing therapy was also generally well-tolerated according to the results.
Beta blockers have a variety of different uses in the management of ischemic heart disease. This presentation by Dr Vivek Baliga, Internal Medicine Physician talks about the role in ST elevation MI.
This presentation deals with the beta blockers commonly used in day-to-day practice alongwith some interesting mnemonics to remember their names & site of action
Beta adrenergic blockers (β-blockers) are a class of drugs that are competitive antagonists of beta-adrenergic receptors. They are used to treat hypertension, ischemic heart disease, cardiac arrhythmias, heart failure, glaucoma, and other conditions. β-blockers are classified as non-selective or cardioselective. Non-selective β-blockers block β1 and β2 receptors, while cardioselective β-blockers selectively block β1 receptors in the heart. β-blockers produce their effects by inhibiting the sympathetic nervous system's stimulation of the heart and circulation. They reduce heart rate, blood pressure, and cardiac contractility, thereby reducing myocardial oxygen demand.
Beta blockers are the most effective therapy for heart failure according to clinical trials. Long term use of beta blockers such as bisoprolol, carvedilol, and sustained release metoprolol succinate can reduce mortality, heart failure hospitalizations, and improve ejection fraction and symptoms of heart failure. While initiation requires slow uptitration, discontinuation of beta blockers during heart failure hospitalization is generally not necessary and may worsen outcomes.
1. Beta-blockers are not recommended as initial treatment for uncomplicated hypertension but may be beneficial for conditions like angina, heart failure, and recent myocardial infarction.
2. Studies have shown that beta-blockers are less effective at reducing central aortic pressure compared to other drug classes, which may explain their reduced ability to protect against stroke.
3. While beta-blockers reduce mortality when used for approved indications like heart failure, their long-term benefits after myocardial infarction are unclear as studies have shown no additional survival benefit with long-term adherence compared to discontinuation after one year.
Beta-blockers in cardiovascular diseasesKunal Mahajan
This document discusses beta blockers and their use in cardiovascular diseases. It begins with a brief history of beta blockers and their development. It then discusses the classification of beta blockers and their selectivity for beta-1 and beta-2 receptors. Various beta blockers such as bisoprolol, atenolol, and metoprolol are compared in terms of their selectivity, pharmacokinetic properties, and clinical indications. Studies are summarized that show bisoprolol provides greater 24-hour blood pressure control and greater nighttime blood pressure reduction compared to atenolol. The document concludes by stating bisoprolol is highly beta-1 selective, has once-daily dosing and proven benefits in heart failure.
This document provides information on the export of the active pharmaceutical ingredient (API) Nebivolol HCl from India in 2014. It states that India exported 11.5 metric tons of Nebivolol HCl that year, with the USA being the biggest import market. It also lists the top exporting ports and monthly export amounts from India. The document provides export analyses of numerous other APIs and includes a list of over 200 pharmaceutical products and APIs.
This document provides information about the beta blocker Betabis (Bisoprolol hemifumarate USP) including its composition, indications, dosage, side effects and positioning compared to other beta blockers. Betabis is a highly selective beta-1 blocker that effectively controls high blood pressure and angina. It shows no impact on lipid or blood glucose levels, making it safer for diabetes patients compared to non-selective beta blockers.
Dr. Onn Akbar Ali is a cardiologist who has moved his practice from Australia to Malaysia. He was previously a consultant cardiologist at the Queen Elizabeth and Lyell McEwin Hospitals in Australia. As of August 2013, he has been practicing at the KPJ Kajang Specialist Hospital in Malaysia. The document provides his contact information and updates that he has relocated his practice.
Role of beta blockers in the management of cardiovascular diseasesPHAM HUU THAI
Beta-blockers play an important role in the management of cardiovascular diseases by reducing sympathetic nervous system activation, balancing myocardial oxygen supply and demand, increasing the threshold for ventricular fibrillation during ischemia, and reducing myocardial oxygen consumption. They are indicated for hypertension, ischemic heart disease, arrhythmias, congestive heart failure, and other conditions. Studies show beta-blockers reduce mortality and cardiovascular events in heart failure and post-myocardial infarction more than other drug classes.
Beta blockers such as atenolol have been shown to have a relatively weak effect in reducing stroke compared to other antihypertensive classes such as calcium channel blockers, ACE inhibitors, and thiazide diuretics. Evidence from Cochrane reviews shows that beta blockers do not reduce the risk of coronary heart disease compared to placebo or no treatment, and they may increase the risk of all-cause mortality and total cardiovascular disease compared to calcium channel blockers. While beta blockers lower the risk of total cardiovascular disease compared to placebo primarily by reducing stroke risk, their effect on other outcomes is not better than other classes of antihypertensive medications.
Beta Blockers in current cardiovascular practice Praveen Nagula
betablockers are the drug of choice for prevention of progression of heart failure with mortality benefit, after the evolution of neurohormonal regulation as pathogenesis of heart failure
This document discusses beta-blockers, which are recommended for treating hypertension, angina, and myocardial infarction. Beta-blockers reduce mortality when used acutely and long-term after myocardial infarction. They are as effective for older patients, reducing mortality by 40%. Common side effects include dizziness, fatigue, and hypotension. Beta-blockers work by blocking beta receptors and lowering the cardiac workload and renin release. They should be initiated within days of a myocardial infarction and continued for up to three years.
The REACH Registry study found that beta-blockers do not reduce the risk of cardiovascular events like death, heart attack, or stroke in stable outpatients with or without coronary artery disease. However, beta-blockers were found to lower the risk of secondary outcomes in patients who had a heart attack within the past year. The study followed over 45,000 patients for 4 years on average and compared outcomes in patients taking beta-blockers to those not taking them.
The document summarizes evidence from randomized controlled trials on the use of beta blockers in patients with acute myocardial infarction (AMI). It discusses several landmark trials from the pre-reperfusion, thrombolysis, and primary PCI eras that demonstrated the benefits of early beta blocker initiation in reducing infarct size, ventricular arrhythmias, cardiogenic shock, and mortality following AMI. The COMMIT trial specifically showed that metoprolol reduces reinfarction rates, arrhythmic death, and cardiogenic shock, especially in higher risk Killip class patients.
ABSTRACT
Carvedilol is a cardiovascular drug of multifaceted therapeutic potential, with beta-blocker and vasodilatative activity. These actions confer to the above mentioned beta blocker some beneficial properties on several processes involving cardiovascular system. Carvedilol provides hemodynamic, ant ischemic, anti-proliferative and antiarrhytmic benefits, for its antioxidant neuro humoral and electrophysiological effects. All these actions provide the basis for usefulness of the drug in the treatment of hypertension, coronary heart disease, and congestive heart failure. In this review we report the beneficial properties of Carvedilol and we analyze the rational clinical use of this beta blocker taking special attention on recent clinical trial in heart failure where it appears evidence supporting an important, favorable effect of the drug.
KEYWORDS: Carvedilol, Hypertension, Coronary disease, Hearth failure.
Beta blockers were first developed in 1962 and are proven to decrease cardiovascular morbidity and mortality. They are the cornerstone therapy for systolic heart failure, significantly reducing mortality and hospitalizations. Beta blockers also significantly reduce mortality in acute myocardial infarction and post-MI, lowering the risk of death by up to 40%. They are effective for preventing sudden cardiac death through various mechanisms including reducing heart rate and oxygen demand.
Beta-blockers were developed by Sir James Black in the 20th century and are considered one of the most important medical advances. They are commonly used to treat cardiovascular conditions like hypertension, angina, heart failure, and arrhythmias. Beta-blockers work by blocking beta-adrenergic receptors in the heart and vessels. They have various beneficial effects including reducing heart rate, blood pressure, myocardial oxygen demand, and the risk of arrhythmias. Larger clinical trials demonstrated improved outcomes with beta-blockers in conditions like heart attack and heart failure.
The success of neurohormonal blockade: looking back – looking forward: Beta-b...drucsamal
- The document summarizes the history of beta-blocker treatment for heart failure, from early studies in the 1970s showing potential benefits to large randomized controlled trials in the 1990s and 2000s firmly establishing mortality reduction.
- Key trials included MDC (1993) showing reduced mortality and heart transplantation, CIBIS-II (1999) showing reduced mortality with bisoprolol, MERIT-HF (1999) showing reduced mortality with metoprolol CR/XL, and COPERNICUS (2001) showing reduced mortality, hospitalizations, and worsening heart failure with carvedilol.
- Meta-analyses demonstrated a consistent mortality reduction of approximately 35% associated with beta-blocker use in
1) The study examined the influence of continuing or withdrawing beta-blocker therapy on outcomes in patients hospitalized with heart failure.
2) It found that continuing beta-blocker therapy was associated with lower risks while withdrawing therapy was linked to excess mortality.
3) Continuing therapy was also generally well-tolerated according to the results.
Beta blockers have a variety of different uses in the management of ischemic heart disease. This presentation by Dr Vivek Baliga, Internal Medicine Physician talks about the role in ST elevation MI.
This presentation deals with the beta blockers commonly used in day-to-day practice alongwith some interesting mnemonics to remember their names & site of action
Beta adrenergic blockers (β-blockers) are a class of drugs that are competitive antagonists of beta-adrenergic receptors. They are used to treat hypertension, ischemic heart disease, cardiac arrhythmias, heart failure, glaucoma, and other conditions. β-blockers are classified as non-selective or cardioselective. Non-selective β-blockers block β1 and β2 receptors, while cardioselective β-blockers selectively block β1 receptors in the heart. β-blockers produce their effects by inhibiting the sympathetic nervous system's stimulation of the heart and circulation. They reduce heart rate, blood pressure, and cardiac contractility, thereby reducing myocardial oxygen demand.
Beta blockers are the most effective therapy for heart failure according to clinical trials. Long term use of beta blockers such as bisoprolol, carvedilol, and sustained release metoprolol succinate can reduce mortality, heart failure hospitalizations, and improve ejection fraction and symptoms of heart failure. While initiation requires slow uptitration, discontinuation of beta blockers during heart failure hospitalization is generally not necessary and may worsen outcomes.
1. Beta-blockers are not recommended as initial treatment for uncomplicated hypertension but may be beneficial for conditions like angina, heart failure, and recent myocardial infarction.
2. Studies have shown that beta-blockers are less effective at reducing central aortic pressure compared to other drug classes, which may explain their reduced ability to protect against stroke.
3. While beta-blockers reduce mortality when used for approved indications like heart failure, their long-term benefits after myocardial infarction are unclear as studies have shown no additional survival benefit with long-term adherence compared to discontinuation after one year.
Beta-blockers in cardiovascular diseasesKunal Mahajan
This document discusses beta blockers and their use in cardiovascular diseases. It begins with a brief history of beta blockers and their development. It then discusses the classification of beta blockers and their selectivity for beta-1 and beta-2 receptors. Various beta blockers such as bisoprolol, atenolol, and metoprolol are compared in terms of their selectivity, pharmacokinetic properties, and clinical indications. Studies are summarized that show bisoprolol provides greater 24-hour blood pressure control and greater nighttime blood pressure reduction compared to atenolol. The document concludes by stating bisoprolol is highly beta-1 selective, has once-daily dosing and proven benefits in heart failure.
This document provides information on the export of the active pharmaceutical ingredient (API) Nebivolol HCl from India in 2014. It states that India exported 11.5 metric tons of Nebivolol HCl that year, with the USA being the biggest import market. It also lists the top exporting ports and monthly export amounts from India. The document provides export analyses of numerous other APIs and includes a list of over 200 pharmaceutical products and APIs.
Beta blockers are a class of drugs that are used to treat high blood pressure and heart conditions by blocking beta-adrenergic receptors. There are several types of beta blockers that are categorized based on their selectivity and other properties. Some are cardioselective, meaning they mainly affect the heart, while others are non-selective. Beta blockers have various therapeutic uses for conditions like hypertension, angina, arrhythmias, and migraine prevention. Their effects are primarily cardiovascular in nature by slowing the heart rate and reducing blood pressure. Common adverse effects include worsening heart failure and bronchospasm.
Beta receptor blockers are a class of drugs that are commonly used to treat cardiovascular conditions by blocking beta-1 and beta-2 receptors. They have several therapeutic uses including hypertension, congestive heart failure, angina, myocardial infarction, and cardiac arrhythmias. They work by decreasing heart rate, contractility, and blood pressure. Common side effects include fatigue, bronchospasm, and metabolic abnormalities. First generation blockers are non-selective while later generations are more cardioselective. Carvedilol is used for heart failure, atenolol for hypertension, and esmolol for emergencies. Propranolol is effective for migraine prevention. Timolol eye drops are used for glaucoma treatment by decreasing
Hypertension, or high blood pressure, is a common cardiovascular disease defined by elevated blood pressure in the arteries. It is categorized based on systolic and diastolic blood pressure readings into prehypertension, stage 1 hypertension, stage 2 hypertension, and stage 3 hypertension. There are many risk factors that can contribute to hypertension, and it is classified as either essential or secondary hypertension. Treatment involves use of several classes of antihypertensive drugs, including diuretics, sympatholytics, beta blockers, calcium channel blockers, ACE inhibitors, and others. These drugs work to lower blood pressure through various mechanisms like reducing fluid volume, decreasing sympathetic nervous system activity, blocking adrenoreceptor sites, and inhibiting the renin
The document is an interpretation of an angiogram of the coronary arteries by Dr. Abdul Rab Shaikh. It analyzes images from an angiogram, a medical test that uses x-rays and dye to see inside the heart's blood vessels. The interpretation likely discusses any blockages or abnormalities found in the coronary arteries.
Alpha-Beta adrenergic mixed blockers like carvedilol and labetalol combine alpha and beta blocker effects to lower heart rate and blood pressure. They are used to treat hypertension, pheochromocytoma, heart failure, angina, myocardial infarction, and left ventricular dysfunction. Common adverse reactions include tiredness, bradycardia, hypotension, wheezing, diarrhea, nausea, dizziness, and vertigo. Dosages vary based on the condition and can be administered orally or intravenously.
Beta-blockers are a class of drugs that are used to manage various cardiac conditions by blocking the effects of epinephrine and other stress hormones on beta receptors. They were first developed in the 1950s and revolutionized cardiology. Beta-blockers are indicated for conditions like hypertension, arrhythmias, heart attack, and glaucoma. While they provide important benefits, they can also cause adverse effects like fatigue, dizziness, and bronchospasm. Different beta-blockers have varying levels of selectivity for beta-1 versus beta-2 receptors and some have additional alpha-blocking properties. Guidelines provide recommendations on the appropriate use of specific beta-blockers for different cardiac indications.
This document summarizes several classes of antihypertensive drugs, including their mechanisms of action and effects. It discusses diuretics, ACE inhibitors, angiotensin receptor blockers, beta-blockers, calcium channel blockers, alpha-blockers, centrally acting drugs, and vasodilators. For each class, it describes their advantages and disadvantages in treating hypertension, as well as recommendations for use.
ANTI HYPERTENSIVE AGENTS [MEDICINAL CHEMISTRY] BY P.RAVISANKAR, HYPERTENSION,...Dr. Ravi Sankar
ANTI HYPERTENSIVE AGENTS [MEDICINAL CHEMISTRY] BY P.RAVISANKAR, HYPERTENSION,TYPES,CAUSES OF HYPERTENSION, CLASSIFICATION, MECHANISM OF ACTION, SAR, ACE INHIBITORS, ARB , DIURETICS(WATER PILLS), TIPS TO STOP SILENT KILLER.
BY P. RAVISANKAR, VIGNAN PHARMACY COLLEGE, VADLAMUDI, GUNTUR,A.P, INDIA.
This presentation contains drugs which blocks the adrenergic system e.g receptor blockers like alpha and beta receptor antagonists, adrenergic neuron blocking agents in details.various animated pictures are also included to make the presentation interesting as well as i have used various diagrams and tables to have better understanding of the topic. Thank you.
Beta blockers act on beta 1 and/or beta 2 receptors. They are classified as non-selective, selective, and mixed blockers. Non-selective blockers like propranolol block both beta 1 and beta 2 receptors. They are used for cardiovascular conditions like hypertension, angina, heart failure, and arrhythmias. Adverse effects include bronchospasm, bradycardia, hypoglycemia, and heart failure. Cardioselective blockers mainly block beta 1 receptors. Newer blockers have improved safety profiles.
journal club is one of the important academic activity during MD/MS courses. Present PPT is a journal club presented on an article that compare two antihypertensives and the presentation also includes critical analysis of the article.
This document summarizes different types of antihypertensive drugs. It discusses drugs that act centrally to reduce sympathetic outflow, drugs that act on autonomic ganglia or postganglionic nerve endings, drugs that act on adrenergic receptors like alpha and beta blockers, drugs that block the renin-angiotensin-aldosterone axis, and direct vasodilators. Specific drugs discussed in detail include methyldopa, clonidine, prazosin, and beta blockers. The document provides information on mechanisms of action, uses, doses, and side effects of these antihypertensive drugs.
The document discusses the heart and hypertension. It defines normal blood pressure and describes the types and causes of hypertension. Hypertension usually has no symptoms, but can sometimes cause headaches, confusion or vision changes. Untreated hypertension can damage blood vessels and the heart over time, so treatment is important even in asymptomatic cases. Treatment includes diuretics, ACE inhibitors, calcium channel blockers, and other drugs that work to lower blood pressure by various mechanisms.
This document discusses beta blockers and focuses on bisoprolol. It summarizes that:
1) Beta blockers are a class of drugs used to treat heart conditions like heart failure and hypertension, but they have diverse properties. Bisoprolol is a selective beta-1 blocker.
2) Studies show bisoprolol provides similar or better blood pressure control compared to other beta blockers like atenolol and metoprolol. It also provides superior heart rate reduction.
3) The CIBIS II trial found bisoprolol reduced all-cause mortality by 34% in heart failure patients when added to standard therapy of diuretics and ACE inhibitors.
FINAL.. beta blockers in cardiovascular disease.pptxdkapila2002
beta blockers have an ever increasing role in many cardiovascular disorders like heart failure,heart attacks,hypertension & SIHD. With new_generation beta-blockers,their efficacy has increased with fewer side effects.They now have a very important role in heart-failure & CAD,while lesser role in management of hypertension.Their present status in CV disorders according to latest guidelines is highlighted.The so called thierd generation betablockers have shown better efficacy with fewer side-effects though large scale randomized trials are lacking
This document summarizes different classes of antihypertensive drugs, including their mechanisms of action and effects. It discusses diuretics, beta blockers, calcium channel blockers, ACE inhibitors, and their uses, sites of action, and potential adverse effects in treating hypertension. Combination drug therapies are recommended for patients who require treatment from multiple drug classes to control their blood pressure.
This document discusses pharmacological management options for heart failure with reduced ejection fraction (HFrEF). The goals of treatment are to reduce symptoms, prolong survival, improve quality of life, and prevent disease progression. Key drug therapies recommended for prognosis include ACE inhibitors, ARBs, beta blockers, and mineralocorticoid receptor antagonists. Diuretics and digoxin are recommended to treat symptoms. Ivabradine may also be used for symptom control. Clinical trials have demonstrated the benefits of these drug classes in reducing mortality and hospitalizations.
- Bisoprolol is a highly selective beta-1 blocker used to treat heart failure, hypertension, and myocardial infarction.
- Studies show bisoprolol lowers blood pressure and heart rate more effectively than atenolol, with greater reductions throughout the day.
- The CIBIS II trial found adding bisoprolol to standard heart failure treatment reduced all-cause mortality by 34% and reduced hospitalizations compared to placebo.
Beta-blockers are a class of drugs that are commonly used to treat cardiovascular conditions. However, one size does not fit all patients. There are several types of beta-blockers that have different mechanisms of action and properties. The document discusses the types of beta receptors, how different beta-blockers work, their pharmacokinetic properties, indications for use, potential adverse effects and controversies regarding their use. It provides a comprehensive overview of beta-blockers for cardiovascular conditions.
Adrenergic blockers, also known as sympatholytics, are drugs that bind to adrenergic receptors but do not trigger the usual intracellular effects. They have the opposite effect of adrenergic agents and block alpha and beta receptor sites. Major classes include alpha blockers, beta blockers, and drugs that affect neurotransmitter release or uptake. Alpha blockers are further divided into non-selective, alpha1-selective, and drugs with additional beta blocking effects. Beta blockers include non-selective, cardioselective, and those with partial agonist activity. Drugs like reserpine and guanethidine deplete neurotransmitters from adrenergic nerves by blocking storage or release.
Adrenergic blockers, also known as sympatholytics, are drugs that bind to adrenergic receptors but do not trigger the usual intracellular effects. They have the opposite effect of adrenergic agents and block alpha and beta receptor sites. Major classes include alpha blockers, beta blockers, and drugs that affect neurotransmitter release or uptake. Alpha blockers are further divided into non-selective, alpha1-selective, and drugs with additional beta blocking effects. Beta blockers include non-selective, cardioselective, and those with partial agonist activity. Drugs like reserpine and guanethidine deplete neurotransmitters from nerve endings. Common uses are for hypertension, angina, migraine and
Ibutilide is an antiarrhythmic drug that was recently marketed for the rapid conversion of atrial fibrillation and atrial flutter. After intravenous administration, ibutilide is moderately effective in achieving prompt cardioversion to sinus rhythm, with greater efficacy in patients who have atrial flutter. Like other drugs that prolong ventricular repolarization, ibutilide administration carries a risk of excessive QT prolongation, or the acquired long-QT syndrome, with associated polymorphic ventricular tachycardia (torsade de pointes), necessitating careful patient selection and clinical monitoring during drug administration.
Heart failure treatment european guidlines 2012Basem Enany
This document provides guidelines for the treatment of systolic heart failure. It recommends treating patients with angiotensin-converting enzyme inhibitors, beta-blockers, and mineralocorticoid receptor antagonists to relieve symptoms, prevent hospitalization, and improve survival. It discusses the benefits and side effects of these drug classes. The document also addresses other treatments such as digoxin, diuretics, ivabradine, and device therapies. It provides guidance on managing heart failure with preserved ejection fraction as well as heart failure complicated by atrial fibrillation.
β-Blockers are effective in treating several cardiovascular conditions such as angina, arrhythmias, myocardial infarction, and congestive heart failure. They are also used for hyperthyroidism, glaucoma, and migraine prevention. β-Blockers are competitive antagonists that lower blood pressure and heart rate by blocking β-adrenergic receptors. They have various mechanisms of action depending on their selectivity for β1 and β2 receptors, intrinsic sympathomimetic activity, lipid solubility, and ability to block alpha receptors or potassium channels. Common adverse effects include bradycardia, hypotension, bronchospasm, fatigue and sexual dysfunction.
This document provides information on beta blockers (BBs), including a brief introduction on how they work, their classification into selective and non-selective types, and their major clinical uses in conditions like angina, heart failure, hypertension and migraine. It discusses their mechanisms of action in treating these conditions and lists their adverse effects and contraindications. The document is presented by Dr. Rajesh Kumar Shah and covers BBs in a comprehensive yet concise manner through headings, bullet points and paragraphs.
Managing heart failure in eldery presentationindanasp
The document discusses managing heart failure in elderly patients and the role of the beta-blocker nebivolol. It notes that most heart failure patients are elderly, and they often have complex comorbidities. The SENIORS trial found that nebivolol significantly reduced mortality and hospitalization in elderly heart failure patients compared to placebo, and had similar benefits regardless of ejection fraction. The document concludes that beta-blockers like nebivolol can be recommended for elderly heart failure patients.
This document describes the benefits of the single-pill combination of bisoprolol and perindopril (Cosyrel). It provides evidence from clinical trials demonstrating the cardioprotective effects of bisoprolol and the benefits of perindopril in reducing major cardiovascular events when used individually or in combination. The combination provides 24-hour blood pressure control from one daily pill and has been shown to reduce cardiovascular mortality and other outcomes compared to placebo in patients taking a beta-blocker.
This document discusses β-adrenergic blockers (β-blockers), which are effective in treating several cardiovascular conditions like angina, arrhythmias, hypertension, and congestive heart failure. It covers the classification of β-blockers based on their selectivity, intrinsic sympathomimetic activity, lipid solubility, and ability to block alpha receptors. The main pharmacological effects and clinical uses of β-blockers are reducing heart rate and contractility, lowering blood pressure, and decreasing intraocular pressure for glaucoma. Adverse effects can include bradycardia, bronchospasm, fatigue, and sexual dysfunction.
This document discusses the vital and novel roles of anti-adrenergic drugs. It begins by introducing anti-adrenergic drugs and their mechanisms of action in inhibiting the neurotransmitters epinephrine and norepinephrine. The document then classifies adrenoceptors and discusses their functions and distribution. It categorizes anti-adrenergic drugs into alpha blockers, beta blockers, and mixed acting blockers. For each category, it provides examples, mechanisms of action, and vital roles in treating conditions like hypertension, heart failure, benign prostatic hyperplasia, prostate cancer, and more. In conclusion, the document states that anti-adrenergic drugs have wide therapeutic applications and can treat multiple
ACEI/ARB are effective medications for treating heart failure (HF) and reducing morbidity and mortality after acute coronary syndrome (ACS). For HF, ACE inhibitors (ACEI) or angiotensin receptor blockers (ARB) are recommended to reduce HF hospitalizations and death by inhibiting the renin-angiotensin-aldosterone system. In ACS patients, ACEI reduce death from cardiovascular causes after myocardial infarction based on evidence from large randomized controlled trials. The combination of an ARB with neprilysin inhibition provides additional benefits for symptomatic HF patients beyond ACEI or ARB alone.
This document discusses beta blockers (betabloqueantes), including their mechanisms of action, characteristics, pharmacokinetics, and side effects. It notes that beta blockers work by blocking beta-1 receptors in the heart and beta-2 receptors in the lungs and blood vessels. They can be classified based on their cardioselectivity, intrinsic sympathomimetic activity, alpha-blocking activity, and lipophilicity. Common side effects include bradycardia, heart failure, bronchospasm, metabolic effects like hyperkalemia and hypoglycemia, central nervous system effects, and withdrawal effects after abrupt discontinuation. The document provides details on various individual beta blockers.
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These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
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1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
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1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
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Mercurius is named after the roman god mercurius, the god of trade and science. The planet mercurius is named after the same god. Mercurius is sometimes called hydrargyrum, means ‘watery silver’. Its shine and colour are very similar to silver, but mercury is a fluid at room temperatures. The name quick silver is a translation of hydrargyrum, where the word quick describes its tendency to scatter away in all directions.
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2. Pharmacological Characteristics of Commonly
Used β-Blockers
1
Table 1.
Price Per Month8
Selectivity Vasodilation ISA Dosing
Β-blocker
(max frequency)
$
Acebutolol Cardioselective No + qd/bid 33
Atenolol Cardioselective No - qd 13
Bisoprolol Cardioselective No - qd 35
Bystolic (Brand) Cardioselective Yes - qd 56
Coreg CR (Brand) Nonselective Yes - qd 123
Carvedilol bid 30
Labetalol Nonselective Yes + bid 21
Metoprolol Cardioselective No - qd 35
Succinate
Propranolol Nonselective No - bid 26
3. HIGHLIGHTS
Bystolic is a Beta-adrenergic blocking agent with high β-1 selectivity no ISA or alpha-
,
adrenergic blocking effects, and nitric oxide mediated vasodilatory effects. 2
Demonstrates efficacy in a broad range of patient populations, including African
Americans, who often have reduced levels of nitric oxide. 3
The nitric oxide mediated vasodilatory effect improves arterial stiffness and endothelial
dysfunction which may be useful for heart failure, diastolic dysfunction, and reducing
cardiovascular risk. 3
Decreases systemic vascular resistance & increases stroke volume while maintaining
cardiac output. 2
Well tolerated and may be effective in reducing the morbidity and mortality in patients of
age>70 years with heart failure regardless of the initial ejection fraction.4
Effective for isolated systolic hypertension. 3
Convenient once daily dosing with fewdrug interactions and side effects. 2
4. Lower incidence of side effects commonly associated with the
use of β-blockers (fatigue, ED, bradycardia, depression)1
Does not negatively affect lipid profile, insulin sensitivity or
,
glycemic control.4
Lowrates of bronchoconstriction & peripheral vasoconstriction.1
Tolerability is similar to that of placebo and may improve patient
compliance.4 (Table 2)
Treatment Placebo
Table 2.2
Headache 6-9% 6%
Fatigue 2-5% 1%
Dizziness 2-4% 2%
Nausea 1-3% 0%
Diarrhea 2-3% 2%
Bradycardia 0-1% 0%
Dyspnea 0-1% 0%
5. TIER 1 ALTERNATIVE
METOPROLOL SUCCINATE (TOPROL XL)
Currently the highest prescribed β-Blocker within your plan: 39%
of total β-Blocker claims for 20075
β-1 Selective6
JNC7 Guidelines recognize this agent as being cardioprotective7
Approved for use in CHF. Shown to reduce morbidity & mortality
in patients with CHF. 5
The incidence of adverse events commonly associated with β-
Blockers for Metoprolol Succinate is low Toprol XL Prescriber
.
Information contains the following information regarding adverse
events:6
Serious adverse events and adverse events leading to discontinuation of study medication in MERIT-HF at an
incidence >1% in the group receiving TOPROL-XL and greater than placebo by more than 0.5% were
dizziness/vertigo (1.8% vs 1.0%), bradycardia (1.5% vs 0.4%), and accident and/or injury (1.4% vs 0.8%)
Other adverse events with an incidence >1% on Toprol XL and as common on placebo (within 0.5%)
included myocardial infarction, pneumonia, cerebrovascular disorder, chest pain, dyspnea,
dyspnea/aggravated syncopy coronary artery disorder, ventricular tachycardia/arrythmia aggravated,
,
hypotension, diabetes mellitus/aggravated, abdominal pain and fatigue.
QD Dosing6
Monthly cost: ~$358
6. RECOMMENDATIONS
Bystolic may be beneficial in these populations:
Elderly (Higher incidence of falls and comorbidities)
African Americans (Less responsive to other β-blockers & often have
reduced levels of nitric oxide)
Patients intolerant to side effects common to other beta blockers
(fatigue, dizziness, bradycardia, bronchoconstriction, hyperglycemia)
Possibly useful for patients with heart failure (↓SVR, ↑SV, ↔CO)
Patients on optimized conventional therapy with uncontrolled HTN
(Approved as add on therapy for the treatment of HTN)
Formulary Considerations
Monthly cost ~$568
Tier 2 with Step Therapy
Must have been on at least one other β-blocker
Tier 3
7. REFERENCES
Forest Laboratories, Inc. Product Monograph ‘Bystolic’. 2007
1.
Miko, Leandra. Bystolic – Nebivolol. www.gahec.org/pharmupd/Bystolic.ppt.
2.
01/24/2008
Cockcroft, John. A review of the safety and efficacy of nebivolol in the mildly
3.
hypertensive patient. Vascular Health and Risk Management 2007:3 (6) 909-917
Rosei, Enrico Agabiti. Rizzoni, Damiano. Metabolic Profile of Nebivolol, a
4.
Adrenoceptor with Unique Characteristics. Drugs 2007;67 (8) 1097-1107
Medinitiatives.com
5.
Astra Zeneca. Prescribing Information. http://www1.astrazeneca-us.com/pi/toprol-
6.
xl.pdf. 2007
U.S. Department of Human and Health Services. The Seventh Report of the Joint
7.
National Committee on Prevention, Detection, Evaluation, and Treatment of High
Blood Pressure. http://www.nhlbi.nih.gov/guidelines/hypertension/jnc7full.htm.
2004
http://www.drugstore.com/
8.