The beta blockers (examples: atenolol, metoprolol, propranolol) act as competitive antagonists at the adrenergic beta receptors. The newer agents tend to be more selective for the cardiac (beta-1) receptors which allows for decreased systemic side effects. Most of the generic names for beta blockers end with "olol".

INDICATIONS

• angina
• anxiety+
• atrial fibrillation
• atrial flutter
• esophageal varices+
• ethanol withdrawal+
• glaucoma
• hypertension
• hypertensive emergency+
• hypotension induction+
• idiopathic hypertrophic subaortic stenosis
• migraine prophylaxis
• myocardial infarction prophylaxis
• myocardial infarction
• ocular hypertension
• paroxysmal supraventricular tachycardia
• perioperative hypertension+
• pheochromocytoma
• portal hypertension+
• scleroderma renal crisis +
• thyrotoxicosis
• tremor
• variceal bleeding prophylaxis+
• ventricular arrhythmias

+ = not an FDA approved indication

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Side Effects and Adverse Reactions

• agranulocytosis
• alopecia
• angina
• arthralgias
• asthenia
• AV block
• bronchospasm
• cardiac arrest
• depression
• diaphoresis
• diarrhea
• dizziness
• dyspepsia
• dyspnea
• edema
• ejaculation dysfunction
• elevated hepatic enzymes
• exfoliative dermatitis
• fatigue
• hallucinations
• headache
• heart failure
• hepatic necrosis
• hyperglycemia
• hypoglycemia
• hypotension
• impotence
• insomnia
• jaundice
• lacrimation
• libido decrease
• myalgia
• nausea/vomiting
• nightmares
• ocular irritation
• orthostatic hypotension
• paresthesias
• peripheral vasoconstriction
• peripheral edema
• pharyngitis
• priapism
• pruritus
• QT prolongation
• sinus bradycardia
• skin hyperpigmentation
• syncope
• torsade de pointes
• urinary retention
• ventricular fibrillation
• ventricular tachycardia
• wheezing
• xerosis

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