Non-cardioselective beta blockers

What are Non-cardioselective beta blockers?

Beta adrenergic blocking agents prevent stimulation of the beta adrenergic receptors at the nerve endings of the sympathetic nervous system and therefore decrease the activity of the heart. They block sympathetic stimulation of the heart and reduce systolic pressure, heart rate, cardiac contractility and output, so decrease myocardial oxygen demand and increase exercise tolerance.

Beta adrenergic blocking agents are used to treat angina, control abnormal heart rhythms and to reduce high blood pressure. However, non-cardioselective beta blockers can cause significant bronchial constriction and could be harmful especially in patients with respiratory conditions such as asthma or chronic obstructive pulmonary disease.

Notable non-cardioselective beta blocker drugs are propranolol, nadolol, labetalol, carvedilol, and sotalol. Some non-cardioselective beta-blockers, such as bucindolol, labetalol, and carvedilol can also act on alpha-1 receptors, which could be an effective combined treatment for hypertension.

The beta-adrenergic receptor antagonists (beta-blockers) are a family of agents that are widely used to treat hypertension, angina pectoris and cardiac arrhythmias. Beta-blockers are also used for migraine prophylaxis, to treat anxiety, to prevent essential tremor, and to block the side effects of hyperthyroidism. Nonspecific beta-blockers are also recommended for treatment of portal hypertension in patients with cirrhosis.

The beta-blockers act by competing with beta-adrenergic agonists (such as epinephrine and norepinephrine) for beta-receptor sites. Beta-blockers are often categorized as “selective” or “non-selective” based upon whether they block both beta-1 receptors that are predominantly present in cardiac muscle and beta-2 receptors found in bronchial and smooth muscles. Beta-1 selective blockers are preferred for therapy of heart disease, whereas the nonselective beta-blockers are preferred as therapy to prevent recurrent variceal hemorrhage in patients with cirrhosis and portal hypertension. Nonselective beta-blockers (common brand name and the year of their approval for use in the United States) include propranolol (Inderal, 1967), nadolol (CorGard, 1979), pindolol (Visken, 1982), labetalol (Normodyne, Trandate, 1984), penbutolol (Levatol, 1987), sotalol (Betapace, 1992), carvedilol (Coreg, 1995), and timolol (Biocarden, 1995). Beta-1 selective blockers include metoprolol (Lopressor, Toprol, 1978), atenolol (Temormin, 1981), acebutolol (Sectral, 1984), betaxolol (Kerlone, 1985), esmolol (Brevibloc, 1986), bisoprolol (Zebeta, 1992) and nebivolol (Bystolic, 2008).