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INTRODUCTION

Beta adrenergic receptors blocking agents, commonly called beta blockers compete with B agonist for B1 or B2 receptors sites.
Beta 1 receptors are primarily in the heart. They are also present at sympathetic nerve ending where they are associated with increase norepirephrine release. In the kidney they increases rennin, in fat cells increases lipolytes.

Beta 1

B2

B2 receptors are present in the bronchial and vascular smooth muscles. They are also present in Skeletal muscle where they increases potassium uptake and glycogenolysis, and in the pancreas they are associated with increases of insulin. B1 and B2 receptors are used as antihypertensive drugs. These drugs reduce blood pressure by blocking sympathetic effects on the heart thus decreasing the heart rate and cardiac output. They are also decrease blood pressure by blocking adrenergic nerve mediated release of rennin. They also reduce the peripheral vascular resistance.

DEFINITION

Beta blockers are type of drugs that effect over body response to certain nerves. Are used to control abnormal heart beat like arrhythmias and to treat Angina.

DISTRIBUTION OF BETA RECEPTORS


Organ Heart Receptor Effect of Stimulation B1 Increased heart rate Increased cardiac B1 contractility Acceleration of AV B1 conduction B2 Dilation B2 Dilation B1 Release of renine B1 Increased in free faty acids B2 Increased in blood sugar

Bronchi Artrioles Kidney Metabolism Metabolism

GROUPS OF BETA BLOCKERS


Drugs Propranolol (Inderal) Metoprolol (Mepressor) Poprol x L Atenolol (Tenormin) Nadolol (Corgard) Penbatolol (Levatol) Timolol Maleate (Blocadren) Pindolol (Visken) Acebutolol Sectral Carteolol Hydrochloride (Catrol) Route Oral I/V Oral Oral I/V Oral I/V Oral Oral Oral Oral Oral Onset of Action 30 mint Immediate > 01 hour 1 hour mints > 3 hrs immediate 15 mints 30 mints < 1 hour 1 hour < 1 hour Peak Action 2 4 hrs 2 mint 1 hour 2 4 hrs 20 mint 3 4 hrs 5 mints 1 - 3 hrs 1- 3 hrs 1 hour 2 - 3 hrs 1 3 hrs Duration of Action 8 12 hrs 15 mint 13 19 hrs 24 hours 5 8 hrs 20 24 hrs 7 hrs 20 24 hrs 12 hrs 24 hrs 24 30 hrs 24 hrs

INDICATION

They are considered as a drug of choice in obese patient and in younger clients with hyperdynamic Circulation. B blockers are specifically recommended for the client who have experienced (i) IHD (ii) Angina (iii) MI because they reduce the risk of subsequent episode. B blockers are used cautiously to treat hypertension in clients with Asthma, Insulin dependent diabetes, peripheral vascular disease and CHF. Use of B blockers effect B2 adrenergic receptors that mediate bronchodilation.

ON CONTRAINDICATION
Client with chronic bronchitis asthema. Response of beta blockers are poor in elderly patient. Hypotension Liver toxity Avoid with use of nasal decongestion.

SIDE EFFECTS OF BETA BLOCKERS


Nausea Vomiting Liver toxity Rash Abdominal pain Jaundice Change in colour of stool

COMPLICATIONS

Cardiogenic shock. Arrthmias Unconsciousness Heart failure Heart block

ATENOLOL (TENORMIN)
Atenolol is a selective B1 receptors antagonist a drug belonging to the group of beta blockers. A class of drug that uses primarily in cardiovascular diseases. Excretion: Renal Lactic: In lactiferous female Formula: C14 H22 N2 O3

FUNCTION
Slowing down its heart and reducing its work load. Unlike propranolol atenolol does not pass through the blood brain barriers thus avoiding various central nervous system side effects.

INDICATION

Atenolol is indicate for a number of condition include: Hypertension Angina Acute M.I Supra ventricular tachycardia

CONTRAINDICATION

Bradycardia Cardiogenic shock Metabolic acidosis AV block second & third degree heart block CHF

SIDE EFFECTS

Indigosion, Constipation, Diziness, Faonness, Cold Extremities, Depression. Rhinitis, Impotence, Confusion, Fatigue, Rash, Hypotension, Some Serious Side Effects May Require Urgent Treatment. Mepressor A beta blocker used primely to treat the hypertension and Angina pectoris

NURSING INTERVENTION
Nursing Intervention Rational

1. Monitor for urinary 1. It may be a sign of hesilency (hypertrophic decrease blood supply prostatic) due to hyptension 2. Monitor for syncopy 2. Over dose of drug
3. Monitor for vital sign 3. Adrnergic antagonist can level of consciousness exacerbate existing and mood mental depression 4. Monitor for dizziness, 4. Decreased blood flow to drawsiness and headache the brain. Hypotensive.