A report on Beta blocker

Skeletal formula of propranolol, the first clinically successful beta blocker
Dichloroisoprenaline, the first beta blocker

Beta blockers, also spelled β-blockers, are a class of medications that are predominantly used to manage abnormal heart rhythms, and to protect the heart from a second heart attack after a first heart attack (secondary prevention).

- Beta blocker
Skeletal formula of propranolol, the first clinically successful beta blocker

81 related topics with Alpha

Overall

An 80 mg capsule of extended-release propranolol

Propranolol

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An 80 mg capsule of extended-release propranolol
A mixture of 20 mg and 10 mg propranolol tablets
Propranolol

Propranolol, sold under the brand name Inderal among others, is a medication of the beta blocker class.

A myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, causing catastrophic thrombus formation, totally occluding the artery and preventing blood flow downstream.

Myocardial infarction

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A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle.

A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle.

A myocardial infarction occurs when an atherosclerotic plaque slowly builds up in the inner lining of a coronary artery and then suddenly ruptures, causing catastrophic thrombus formation, totally occluding the artery and preventing blood flow downstream.
Cross section showing anterior left ventricle wall infarction
Diagram showing the blood supply to the heart by the two major blood vessels, the left and right coronary arteries (labelled LCA and RCA). A myocardial infarction (2) has occurred with blockage of a branch of the left coronary artery (1).
A 12-lead ECG showing an inferior STEMI due to reduced perfusion through the right coronary artery. Elevation of the ST segment can be seen in leads II, III and aVF.
ECG : AMI with ST elevation in V2-4
Inserting a stent to widen the artery.

After an MI, lifestyle modifications, along with long-term treatment with aspirin, beta blockers and statins, are typically recommended.

A man with congestive heart failure and marked jugular venous distension. External jugular vein marked by an arrow.

Heart failure

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Set of manifestations caused by the failure of the heart's function as a pump supporting the blood flow through the body.

Set of manifestations caused by the failure of the heart's function as a pump supporting the blood flow through the body.

A man with congestive heart failure and marked jugular venous distension. External jugular vein marked by an arrow.
Signs and symptoms of severe heart failure
Severe peripheral pitting edema
Kerley B lines in acute cardiac decompensation. The short, horizontal lines can be found everywhere in the right lung.
Model of a normal heart (left); and a weakened heart, with over-stretched muscle and dilation of left ventricle (right); both during diastole
Chest radiograph of a lung with distinct Kerley B lines, as well as an enlarged heart (as shown by an increased cardiothoracic ratio, cephalization of pulmonary veins, and minor pleural effusion as seen for example in the right horizontal fissure. Yet, no obvious lung edema is seen. Overall, this indicates intermediate severity (stage II) heart failure.
Siderophages (one indicated by white arrow) and pulmonary congestion, indicating left congestive heart failure
Ultrasound showing severe systolic heart failure
Congestive heart failure with small bilateral effusions
Kerley B lines

In those with heart failure due to left ventricular dysfunction, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, or valsartan/sacubitril along with beta blockers are recommended.

Ventricular fibrillation (VF) showing disorganized electrical activity producing a spiked tracing on an electrocardiogram (ECG)

Arrhythmia

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Too fast or too slow.

Too fast or too slow.

Ventricular fibrillation (VF) showing disorganized electrical activity producing a spiked tracing on an electrocardiogram (ECG)
Broad classification of arrhythmias according to region of heart required to sustain the rhythm
Normal sinus rhythm, with solid black arrows pointing to normal P waves representative of normal sinus node function, followed by a pause in sinus node activity (resulting in a transient loss of heartbeats). Note that the P wave that disrupts the pause (indicated by the dashed arrow) does not look like the previous (normal) P waves – this last P wave is arising from a different part of the atrium, representing an escape rhythm.

Medications for a fast heart rate may include beta blockers, or antiarrhythmic agents such as procainamide, which attempt to restore a normal heart rhythm.

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Alpha blocker

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Alpha-blockers, also known as α-blockers or α-adrenoreceptor antagonists, are a class of pharmacological agents that act as antagonists on α-adrenergic receptors (α-adrenoceptors).

Alpha-blockers, also known as α-blockers or α-adrenoreceptor antagonists, are a class of pharmacological agents that act as antagonists on α-adrenergic receptors (α-adrenoceptors).

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Schematic of G Protein Coupled Receptor Signaling, representing Gi GPCR signaling, Gs GPCR signaling, and Gq GPCR signaling.
An image of a patient with pheochromocytoma. In patients with this disease, a catecholamine-secreting tumor is formed, and causes excess CNS stimulation, such as excess sweating and tachycardia. Nonselective alpha blockers, such as phenoxybenzamine or phentolamine, can be used to mitigate this disease.
Benign prostate hyperplasia, a disease in which urinary retention becomes an issue. Alpha-1 blockers can be used, but it can result in side effects such as increased urination and retrograde ejaculation.
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Finally, the agents carvedilol and labetalol are both α and β-blockers.

Metoprolol

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Metoprolol, sold under the brand name Lopressor, among others, is a selective β1 receptor blocker medication.

Triiodothyronine (T3, pictured) and thyroxine (T4) are both forms of thyroid hormone.

Hyperthyroidism

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Condition that occurs due to excessive production of thyroid hormones by the thyroid gland.

Condition that occurs due to excessive production of thyroid hormones by the thyroid gland.

Triiodothyronine (T3, pictured) and thyroxine (T4) are both forms of thyroid hormone.
Illustration depicting enlarged thyroid that may be associated with hyperthyroidism
Most common causes of hyperthyroidism by age.

Medications such as beta blockers may control the symptoms, and anti-thyroid medications such as methimazole may temporarily help people while other treatments are having an effect.

Normal remnant adrenal gland (left) with a pheochromocytoma (right) involving the adrenal medulla

Pheochromocytoma

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Rare tumor of the adrenal medulla composed of chromaffin cells, also known as pheochromocytes.

Rare tumor of the adrenal medulla composed of chromaffin cells, also known as pheochromocytes.

Normal remnant adrenal gland (left) with a pheochromocytoma (right) involving the adrenal medulla
Adrenal gland; the medulla (center, red) is the origin of the adrenal gland
There are two adrenal glands, highlighted in yellow, on top of each of the kidneys
Structure of epinephrine
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FDG PET – the tumor is appreciated as the dark structure in the patient's left chest. Darkened structures at head of patient is brain, in the abdomen are the kidneys, in the pelvis is the bladder. These are normal.
Histopathology on the resected tumor confirms the diagnosis, by typical features as shown.
Patient receiving radiation therapy to the region of the head and neck. Full facial mold is in-place to protect areas where they do not want exposure
Top: Purple lesions are metastatic disease detected with DOTATATE imaging. Bottom: Same patient. Purple lesions are metastatic disease detected with FDG PET
Likelihood of diagnosis when an adrenal-nodule is identified; pheochromocytoma is in yellow near the top-right corner
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The Zebra has become a powerful symbol in the pheochromocytoma advocacy community and represents the rare medical cases that are more likely to be misdiagnosed

2) Pharmaceutical Interference: Many prescription, over-the-counter, and illicit substances can interfere with the proper collection of plasma metanephrines and lead to false-positive results. Providers should review a patient's medication list in-detail and have a discussion if temporarily discontinuing any of the interfering medications is possible. The most reported medications to result in falsely elevated metanephrines include: β-adrenoceptor blockers, phenoxybenzamine, tricyclic antidepressants, monoamine oxidase inhibitors, serotonin norepinephrine reuptake inhibitors (SNRI), and methyldopa. As the majority of these medications are commonly prescribed for psychiatric conditions, a conversation with the prescriber may be necessary to facilitate alternative therapeutic options while the patient is undergoing evaluation for a pheochromocytoma. After any possible prescription medications have been held, it is important to review any over-the-counter medications/supplements as well as the commonly used acetaminophen and pseudoephedrine cause false elevations in metanephrine levels. Finally, it is important to have open, non-judgemental discussions about the patient's recreational substance use. Amphetamines, nicotine, and cocaine can result in marked plasma norepinephrine levels.

The biosynthesis of adrenaline involves a series of enzymatic reactions.

Adrenaline

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Hormone and medication which is involved in regulating visceral functions .

Hormone and medication which is involved in regulating visceral functions .

The biosynthesis of adrenaline involves a series of enzymatic reactions.

Overall, "Extensive evidence indicates that epinephrine (EPI) modulates memory consolidation for emotionally arousing tasks in animals and human subjects.” Studies have also found that recognition memory involving adrenaline depends on a mechanism that depends on β adrenoceptors. Adrenaline does not readily cross the blood–brain barrier, so its effects on memory consolidation are at least partly initiated by β adrenoceptors in the periphery. Studies have found that sotalol, a β adrenoceptor antagonist that also does not readily enter the brain, blocks the enhancing effects of peripherally administered adrenaline on memory. These findings suggest that β adrenoceptors are necessary for adrenaline to have an effect on memory consolidation.

β2 adrenoceptor shown binding carazolol (yellow) on its extracellular site. β2 stimulates cells to increase energy production and utilization. The membrane the receptor is bound to in cells is shown with a gray stripe.

Adrenergic receptor

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β2 adrenoceptor shown binding carazolol (yellow) on its extracellular site. β2 stimulates cells to increase energy production and utilization. The membrane the receptor is bound to in cells is shown with a gray stripe.
The mechanism of adrenoreceptors. Adrenaline or noradrenaline are receptor ligands to either α1, α2 or β-adrenoreceptors. α1 couples to Gq, which results in increased intracellular Ca2+ and subsequent smooth muscle contraction. α2, on the other hand, couples to Gi, which causes a decrease in neurotransmitter release, as well as a decrease of cAMP activity resulting in smooth muscle contraction. β receptors couple to Gs, and increases intracellular cAMP activity, resulting in e.g. heart muscle contraction, smooth muscle relaxation and glycogenolysis.

The adrenergic receptors or adrenoceptors are a class of G protein-coupled receptors that are targets of many catecholamines like norepinephrine (noradrenaline) and epinephrine (adrenaline) produced by the body, but also many medications like beta blockers, beta-2 (β2) agonists and alpha-2 (α2) agonists, which are used to treat high blood pressure and asthma, for example.