Drug treatments: Beta blockers

Beta blockers:

• Slow the heart rate
• Ease the workload of the heart
• Reduce blood pressure
• Reduce deaths from heart disease

Many beta blockers are now available, including:

• Propranolol (Inderal)
• Acebutolol (Sectral)
• Atenolol (Tenormin)
• Betaxolol (Kerlone)
• Carteolol (Cartrol)
• Metoprolol (Lopressor/Toprol XL)
• Nadolol (Corgard)
• Penbutolol (Levatol)
• Pindolol (Visken)
• Carvedilol (Coreg)
• Timolol (Blocadren)
• Labetalol (Normodyne)
• Nebivolol (Bystolic)

The drugs may differ in their effects and benefits.

Problems with beta blockers

On the downside, studies suggest an increased risk of developing type 2 diabetes in people who take beta blockers. Also, people who already have diabetes should use caution taking beta blockers with other high blood pressure medications. This is because beta blockers may mask the symptoms of hypoglycemia (low blood sugar), which can be dangerous.

Because beta blockers can narrow bronchial airways, patients with asthma, emphysema, and chronic bronchitis should be cautious when taking beta blockers and should watch for signs of increased wheezing or shortness of breath. Some beta blockers tend to lower HDL cholesterol (the "good" cholesterol).

In general, the benefits of beta blocker therapy usually outweigh the side effects.

Side effects

Possible side effects include:

• Fatigue and lethargy
• Sexual dysfunction/erectile dysfunction
• Insomnia
• Vivid dreams and nightmares
• Depression
• Memory loss
• Confusion -- especially in the elderly
• Dizziness and light-headedness upon standing
• Lessened capacity for exercise
• Cold hands, fingers, feet, toes
• Decreased heart function
• Stomach and digestive problems -- diarrhea or constipation
• Asthma, emphysema, and bronchitis can be aggravated

If side effects occur, the patient should call a physician, but it is extremely important not to stop the drug abruptly. Angina, heart attack, and even sudden death have occurred in patients who discontinued treatment without gradual withdrawal.

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