Preference for beta blockers

carvedilol IR, bisoprolol and metoprolol succinate are indicated in heart failure to decrease mortality and improve ventricular function.

Confusant said:

According to BNF, beta blockers are generally equally effective (not sure what diseases are these referring to specifically). Does anybody have a specific beta blockers to use when it comes to treatment (e.g. heart failure, high blood pressure)? Thanks!

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Product selection should be patient specific. Does the patient have asthma or CHF? If so, you'll want a beta blocker with high selectivity for beta 1 receptors. Has the patient been bradycardic with beta blockers in the past? in that case, use one with high intrinsic sympathomimetic activity. Does your patient have renal insufficiency? (you may need to adjust the dose of some beta blockers (atenolol) but not others (metoprolol))...There are lots of other characteristics that make individual drugs better choices for certain patients....

Confusant said:

According to BNF, beta blockers are generally equally effective (not sure what diseases are these referring to specifically). Does anybody have a specific beta blockers to use when it comes to treatment (e.g. heart failure, high blood pressure)? Thanks!

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Many of them have the same general efficacy, but vary in other properties that would make them a good or poor choice for an individual patient. See the above posts for details.

bsmspharmd said:

Product selection should be patient specific. Does the patient have asthma or CHF? If so, you'll want a beta blocker with high selectivity for beta 1 receptors. Has the patient been bradycardic with beta blockers in the past? in that case, use one with high intrinsic sympathomimetic activity. Does your patient have renal insufficiency? (you may need to adjust the dose of some beta blockers (atenolol) but not others (metoprolol))...There are lots of other characteristics that make individual drugs better choices for certain patients....

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chuckle beast said:

carvedilol IR, bisoprolol and metoprolol succinate are indicated in heart failure to decrease mortality and improve ventricular function.

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true and think about....the post talking about patient specifics...

I found bisoprolol superior to atenolol. However, consultant then put me on nebivolol for a few months, until taking me off b blockers altogether.
johnep

johnep34 said:

I found bisoprolol superior to atenolol.

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For what indication..?

bsmspharmd said:

Product selection should be patient specific. Does the patient have asthma or CHF? If so, you'll want a beta blocker with high selectivity for beta 1 receptors. Has the patient been bradycardic with beta blockers in the past? in that case, use one with high intrinsic sympathomimetic activity. Does your patient have renal insufficiency? (you may need to adjust the dose of some beta blockers (atenolol) but not others (metoprolol))...There are lots of other characteristics that make individual drugs better choices for certain patients....

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Yes, this above post is very accurate. There are different properties of beta blockers. A couple even have alpha blocker property.

For CHF patients we're looking at carvedilol, metoprolol XL, and bisoprolol for decreased mortality.

For poorly controlled asthma we're looking at the beta1-selective (cardioselective) beta blockers - bisoprolol, atenolol, metoprolol, esmolol (IV only)

whitedc5 said:

For CHF patients we're looking at carvedilol, metoprolol XL, and bisoprolol for decreased mortality.

For poorly controlled asthma we're looking at the beta1-selective (cardioselective) beta blockers - bisoprolol, atenolol, metoprolol, esmolol (IV only)

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And for portal hypertension, it's propranolol because the cardio-selective BBs don't constrict the vessels in the splanchnic bed.

IN the UK, majority of B blockers prescribed for Blood Pressure. Large use of propranolol for anxiety.
johnep