II. Indications
III. Mechanism
- See Beta Adrenergic ReceptorAntagonist
- Selective Beta Antagonist that primarily inhibits B1 activity by blocking B1 Receptors
- Reduces Myocardial Contractility, Blood Pressure, myocardial oxygen demand
- Also Antiarrhythmic and slows ventricular response in Atrial Fibrillation
- Contrast with non-selective Beta Blockers (e.g. Propranolol)
- Non-selective Beta Blockers also act at B2 Receptors (bronchoconstriction) and B3 Receptors (block lipolysis)
IV. Adverse Effects
- See Beta Blocker
V. Drug Interactions
- See Beta Blocker
VI. Metabolism
-
Bioavailability 90%
- Low first pass hepatic metabolism
- Primarily excreted by the liver
- Lipophilic
VII. Dosing
- Start: 10 mg orally daily
- Start at 5 mg in older patients or with renal Impairment
- Maximum: 20 mg/day
VIII. Safety
- Pregnancy Category C
- Unknown Safety in Lactation
IX. Resources
X. References
- (2019) Presc Lett, Resource #350503, Comparison of Oral Beta Blockers
- (2020) Med Lett Drugs Ther 62(1598): 73-80
- Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 66-7
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
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