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 (myocardial infarction) after a first heart attack (secondary prevention).

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

497 related topics

Relevance

An 80 mg capsule of extended-release propranolol

Propranolol

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.

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

Arrhythmia

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.

Skeletal formula of noradrenaline

Norepinephrine

Organic chemical in the catecholamine family that functions in the brain and body as both a hormone and neurotransmitter.

Organic chemical in the catecholamine family that functions in the brain and body as both a hormone and neurotransmitter.

Skeletal formula of noradrenaline
Norepinephrine degradation. Metabolizing enzymes are shown in boxes.
Norepinephrine (labeled "noradrénaline" in this drawing) processing in a synapse. After release norepinephrine can either be taken up again by the presynaptic terminal, or broken down by enzymes.
Schema of the sympathetic nervous system, showing the sympathetic ganglia and the parts of the body to which they connect.
Brain areas containing noradrenergic neurons.
Chemical structure of octopamine, which serves as the homologue of norepinephrine in many invertebrate species

Beta blockers, which counter some of the effects of noradrenaline by blocking their receptors, are frequently used to treat glaucoma, migraine, and a range of cardiovascular problems.

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

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.

General chemical structure of dihydropyridine calcium channel blockers (dipines)

Calcium channel blocker

Calcium channel blockers (CCB), calcium channel antagonists or calcium antagonists are a group of medications that disrupt the movement of calcium through calcium channels.

Calcium channel blockers (CCB), calcium channel antagonists or calcium antagonists are a group of medications that disrupt the movement of calcium through calcium channels.

General chemical structure of dihydropyridine calcium channel blockers (dipines)
Skeletal formula of verapamil
Structural formula of diltiazem
Lipid emulsion as used in CCB toxicity
Ethanol blocks voltage-gated calcium channel
A calcium channel embedded in a cell membrane.
Immunohistochemical analysis of L-type calcium channel Cav1.3 (CACNA1D) in human adrenal cortex: Marked immunoreactivity was detected in the zona glomerulosa. In the figure: ZG = zona glomerulosa, ZF = zona fasciculata, AC = adrenal capsule. Immunohistochemistry was performed according to published methods.

CCBs have been shown to be slightly more effective than beta blockers at lowering cardiovascular mortality, but they are associated with more side effects.

The biosynthesis of adrenaline involves a series of enzymatic reactions.

Adrenaline

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.

James Black (pharmacologist)

Scottish physician and pharmacologist.

Scottish physician and pharmacologist.

He went to work for ICI Pharmaceuticals in 1958 and, while there, developed propranolol, a beta blocker used for the treatment of heart disease.

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

Hyperthyroidism

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.

Ectopia lentis in Marfan syndrome: Zonular fibers are seen.

Marfan syndrome

Rare multi-systemic genetic disorder that affects the connective tissue.

Rare multi-systemic genetic disorder that affects the connective tissue.

Ectopia lentis in Marfan syndrome: Zonular fibers are seen.
An anterior chest wall deformity, pectus excavatum, in a person with Marfan syndrome
Lens dislocation in Marfan syndrome with the lens being kidney-shaped and resting against the ciliary body
Marfan syndrome is inherited in an autosomal-dominant pattern.
Micrograph demonstrating myxomatous degeneration of the aortic valve, a common manifestation of MFS
Thumb sign; upper: normal, lower: Marfan syndrome

Management often includes the use of beta blockers such as propranolol or atenolol or, if they are not tolerated, calcium channel blockers or ACE inhibitors.

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

Heart failure

Set of manifestations caused by the failure of the heart's function as a pump supporting the blood flow through the body; its signs and symptoms result from a structural and/or functional abnormality of the heart, that disrupts its filling with blood or its ejecting of it during each heart beat.

Set of manifestations caused by the failure of the heart's function as a pump supporting the blood flow through the body; its signs and symptoms result from a structural and/or functional abnormality of the heart, that disrupts its filling with blood or its ejecting of it during each heart beat.

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.