Beta Blockers: In a Nutshell

00:00 Let’s wrap up this video in a nutshell.

00:02 Beta blockers are medications that block the activation of beta adrenergic receptors, so what that receptors created to do is gonna be inhibited or stopped.

00:14 So it blocks the action of norepinephrine and epinephrine at the beta adrenergic receptors, therefore, that’s why beta blocker cause decrease heart rate.

00:23 Teach your patients, check the heart rate and the blood pressure before you ever give a beta blocker.

00:28 It’s gonna decrease your heart rate, the conduction velocity and it will lower the blood pressure which is what we’re after.

00:35 So, the applications in the heart or cardiovascular of beta blockers include treating chest pain, after an MI -- a heart attack, a myocardial infarction, hypertension - because we wanna lower blood pressure, cardiomyopathy -- heart’s have gotten kinda big and mushy, and these really fast super ventricular arrhythmias.

00:55 Now for asthmatic patients, we want to make sure they are very clear - hey, if you start having any shortness of breath, notify us because beta blockers block that activation of the receptors that cause bronchial dilation.

01:07 And not just asthmatic patients, you wanna make sure you tell asthmatic patients but I tell every patient that I’m sending home on a beta blocker, you need to know if you have any breathing problems, contact us, cuz people don’t necessarily connect a beta blocker or a blood pressure medication to shortness of breath.

01:25 Diabetic patients, remember they are not gonna show us the same signs and symptoms for low blood sugar, we won’t see that tachycardia and they cannot respond the way a body normally would to raise that blood sugar because that glycogenolysis is blocked.

01:42 Last, those adverse effects -- symptomatic bradycardia or hypotension.

01:48 So if I have this heart rate that’s so low, I’m just exhausted, my blood pressure is so low I can’t think or I pass out on the gym -- that’s not a good thing.

01:58 That reflex tachycardia is your body’s way trying to overcompensate for that, they might have AV heart block.

02:05 Whoa, what is that? Well, AV is atrioventricular heart block.

02:11 Because this medication slows down the electrical impulses to the heart, if somebody has a heart block, that means the impulse is already slow and if we give them medication like a beta blocker, we might make things just that much worse.

02:27 So people with heart blocks, meaning something is getting in the way of that electrical conductivity of the system, beta blockers are not a good choice.

02:36 People can also develop a heart block so you wanna watch them closely for that.

02:41 Beta blockers cause reduced cardiac output and that could also worsen CHF.

02:48 Okay, that’s a big list. What do you do with those when you're studying like, whoa, gosh, you lost me after the second one - I totally understand, so let’s talk about some study strategies and how you rip that apart.

02:59 Thinking about what beta blockers do, why would an adverse effect be bradycardia? Your turn.

03:13 Right, we definitely decrease the heart rate but symptomatic bradycardia means we got it so low the patient is dizzy or not able to walk safely or was really feeling bad.

03:25 Now, why would an adverse effect of beta blockers be hypotension? Remember what I always say, anything a drug does well, it can do over well and hypotension is not what I’m after.

03:40 Okay, reflex tachycardia.

03:42 Well, we know that beta blockers, unlike a lot of blood pressure medications, directly goes after the electrical conductivity in the heart. This can be when that blood pressure drops too low, you got this weird reflex heart rate going so fast -- that’s a problem.

03:57 AV heart block, remember, I keep saying that, I don’t know if that helps or not, but AV heart block is again, back to that electrical conductivity of the heart, someone could have an heart block that’s made worse by a beta blocker.

04:13 And all these comes together to give me reduced cardiac output and that could make congestive heart failure even worse.

04:21 So when you see a list of these things, don’t be satisfied with just reading through them and saying, yeah, yeah, yeah - you want to take a look at these and one by one ask yourself, why would they experiences this.

04:34 What about this medication would cause that effect? What about this medication would cause that effect? That’s how you really start to make this information your own and you’re not just memorizing things.

04:45 Thank you for watching our video on hypertensive medications today.