00:01
So, what other things can we use them for?
Well, they're actually helpful in
treating angina, chest pain,
especially after an MI. This has been shown
to extend people's quality of life.
00:11
So chest pain, let's stop and think;
why would that be helpful to use a
beta blocker for chest pain?
Well, hey, my heart isn't working as hard,
right? It's not beating as fast.
00:22
It's not beating as hard.
00:24
So the cool part about that is my heart's
not going to need as much oxygen.
00:29
Chest pain is a lack of adequate
oxygen supply.
00:33
If you decrease my workload, then cool,
I'm going to have less chest pain.
00:38
We use beta blockers for long-term
prevention of angina or chest pain.
00:42
Now, after an MI, that heart's
taken a hit, right?
So we want to definitely decrease
the workload on that heart too.
00:50
The reason beta blockers are
helpful in hypertension.
00:55
Let's think about that.
00:56
Well, that one is one we've just hit, right?
Hypertension, because I decrease
the velocity of the
electrical impulse racing through the heart,
I decrease the heart rate. The heart's
not pumping as fast or as hard.
01:10
Now, my cardiac output is lower,
and therefore, my blood pressure
will be lower,
so that will help me treat hypertension.
01:19
Now this one is a little bit touchy. We're
talking about cardiomyopathy,
and that's when your heart can get
kind of too big, or in CHF.
01:28
Okay, those hearts are kind of limping along.
01:30
So we walk this tightrope
with this medication,
because I want to decrease the workload
of the heart just enough
that it's easier for the patient, but not too
much so I throw them into failure.
01:43
So this takes really good communication
with the nurse, the patient, the other
members of the healthcare team,
to help the patient recognize when
they're starting to get into trouble.
01:52
So, beta blockers are really helpful,
but we're constantly watching that dosage
and how the patient is responding
to make sure that we don't get
the heart so cranked down
that it throws them into deeper failure.
02:05
Now, the last one we're talking in this
slide is supraventricular arrhythmias.
02:09
So those are super-fast heart rates,
you can see why beta blocker
would be helpful for that.
02:15
So more importantly than memorizing a list
is when you see the applications
of a medication, is you say,
"Why? Can I answer from the mechanism
of action of this drug?
Why would it be helpful for anigina?
Why would it be helpful for MI?"
So what I would encourage you
to do is pause the video,
and take just a minute to see if
you can walk through
without looking at your notes,
see if you can walk through the reasons
that we would use a beta blocker
and how it would help your patient
have a better quality of life to use
it for all these diagnoses.
02:55
Okay, I hope you're starting to get
the idea of the benefit
of always asking "why?"
Memorizing lists will get you nowhere.
Well, it'll just get you confused.
03:04
If you really want to give the best
patient care to your patients,
this is what you do. Don't settle
for memorization.
03:11
Understand the "why" behind what you're doing
and you're going to be a fantastic nurse.
03:16
Now, let's look at some more. Anxiety. Okay.
03:20
Now, I gave you the answers
on the first slide.
03:22
I want you to see if you can
respond to these --
anxiety. Huh. Okay, what happens
when you're anxious?
I get real nervous, I get real sweaty.
My heart rate goes real fast.
03:31
How would a beta blocker help me with that?
Well, when I'm anxious,
epinephrine and adrenaline is running
through my body, right?
So, if I give you a beta blocker,
it's going to be on those receptors
that make me have that response,
so I'm going to be calmer. In fact,
this is one of my favorite things to
recommend to students who have
true test anxiety. Not the,
"Oh, crap. I didn't study,"
anxiety. I can't fix that
because if I could, I'd be a good
gajillionnaire, wouldn't I?
We could just be smart without
having to study.
04:05
But for true test anxiety,
when your mind goes blank, and you
can't think -- that type of anxiety --
beta blockers are an excellent option,
because they block that panic response.
04:18
So, we've had fantastic results
with recommending
that students with true test anxiety
talk to their health care provider,
and they go on a low-dose beta blocker.
04:28
They only take it on test days. They don't
have to take it for blood pressure control.
04:32
It doesn't make them sleepy.
It's not like a sedative,
but it just blocks that panic attack.
04:38
So if you're someone who suffers
from test anxiety,
consider that. It's a great option
and they're even cheap.
04:44
So it's a really easy solution.
04:46
Essential tremors, same type of thing.
04:48
Migraine headaches.
04:50
We're not even sure why it works
for migraine headaches.
04:53
And frankly,
I wish we were better at treating
migraine headaches than we are.
04:58
For those of you out there that suffer
from migraine headaches,
you have my full empathy.
05:03
When a student tells me they have
a migraine headache,
I don't need to hear anything else.
05:08
I will do whatever I need to to facilitate
it because I don't have them,
but my sister does, and I know
that they are just brutal.
05:16
Some patients can actually be treated for
migraine headaches and get some relief.
05:20
Also works for open-angle glaucoma
and pheochromocytoma.
05:25
Okay, we're ending the trivia, right?
We're getting into trivia land by this.
05:29
For this slide, the one that it's
most important to me
that you take away with you is anxiety.
05:34
So circle that one. That one
you need to know,
the others are nice to know.
And let's be honest,
you only have certain real
estate in your brain,
so part of the interesting part
of nursing school
is learning what is most important,
and the nice-to-know stuff you
could add at a later time.
05:53
But the need-to-know is understanding
how beta blockers work,
and why they help.
05:59
Make sure you know that they treat anxiety,
but also, the major precautions that
we listed on the previous slide.
06:07
So let's take a look at those one more time.
06:09
Chest pain, after an MI, hypertension,
cardiomyopathy, and the super
ventricular arrhythmias.
06:17
So, if the main list that I need to
memorize would be those four
plus anxiety, you're in really,
really good shape.
06:25
And by keeping in mind the mechanism
of action, you should be fine.