Introduction
Beta-blockers are an important class of drug used mainly in the management of cardiovascular disorders.
Indications
- Angina
- Post-myocardial infarction
- Heart failure: beta-blockers were previously avoided in heart failure but there is now strong evidence that certain beta-blockers improve both symptoms and mortality
- Arrhythmias: beta-blockers have now replaced digoxin as the rate-control drug of choice in atrial fibrillation
- Hypertension: the role of beta-blockers has diminished in recent years due to a lack of evidence in terms of reducing stroke and myocardial infarction.
- Thyrotoxicosis
- Migraine prophylaxis
- Anxiety
Adverse effects
- Bronchospasm
- Cold peripheries
- Fatigue
- Sleep disturbances, including nightmares
- Erectile dysfunction
Contraindications
- Uncontrolled heart failure
- Asthma
- Sick sinus syndrome
- Concurrent verapamil use: may precipitate severe bradycardia