Beta-blockers: list of drugs, indications for use

Drugs with important therapeutic effects are widely used by specialists. They are used to treat cardiac diseases, which are the most frequent among the other pathologies. These ailments most often lead to the death of patients. The drugs that are needed to treat these diseases are beta-blockers. The list of drugs of the class, consisting of 4 sections, and their classification are presented below.

Classification of beta-blockers

The chemical structure of the preparations of the class is not homogeneous and the clinical effects do not depend on it. It is much more important to isolate specificity for specific receptors and their affinity for them. The higher the specificity for beta-1 receptors, the less side effects of drugs. In this regard, a complete list of preparations of beta-blockers is rationally presented as follows.

The first generation of drugs:

• Nonselective to beta receptors of the 1 st and 2 nd types: Propranolol and Sotalol, Timolol and Oxprenolol, Nadolol, Penbutamol.

Second generation:

• Selective to beta-receptors of the first type: "Bisoprolol" and "Metoprolol", "Acebutalol" and "Atenolol", "Esmolol".

Third Generation:

• Selective beta-1-blockers with additional pharmacological properties: Nebivolol and Betaxalol, Talinolol and Celiprolol.
• Non-selective beta-1 and beta-2-blockers with additional pharmacological properties: "Carvedilol" and "Cardotolol", "Labetalol" and "Butcindolol".

These beta-blockers (the list of drugs see above) at different times were the main group of drugs that were used and are now used for diseases of blood vessels and heart. Many of them, mainly representatives of the second and third generations, are still used today. Due to their pharmacological effects, it is possible to control the frequency of cardiac contractions and ectopic rhythm to the ventricles, to reduce the frequency of anginal attacks of angina pectoris.

Explanation of classification

The earliest drugs are representatives of the first generation, that is, non-selective beta-blockers. The list of medicines and preparations is presented above. These medicinal substances are able to block the receptors of the 1 st and 2 nd types, having both therapeutic effect and side effect, which is expressed by bronchospasm. Therefore, they are contraindicated in COPD, bronchial asthma. The most important preparations of the first generation are: "Propranolol", "Sotalol", "Timolol".

Among the representatives of the second generation, a list of preparations of beta-blockers has been compiled, the mechanism of action of which is associated with preferential blocking of the receptors of the first type. They are characterized by a weak affinity for Type 2 receptors, so they rarely cause bronchospasm in patients with asthma and COPD. The most important drugs of the second generation are "Bisoprolol" and "Metoprolol", "Atenolol".

The third generation of beta-blockers

Representatives of the third generation are the most modern beta-blockers. The list of drugs consists of Nebivolol, Carvedilol, Labetalol, Butcindolol, Celiprolol and others (see above). The most important from the clinical point of view are the following: Nebivolol and Carvedilol. The first predominantly blocks beta-1 receptors and stimulates the release of NO. This causes the expansion of blood vessels and a reduced risk of atherosclerotic plaques.

It is believed that beta-blockers are medicines for hypertension and heart disease, whereas Nebivolol is a universal drug that is well suited for both purposes. However, its value is slightly higher than the price of the rest. Similar in properties, but slightly cheaper, is Carvedilol. It combines the properties of beta-1 and alpha-blocker, which allows you to reduce the frequency and strength of the heart contractions, as well as expand the vessels of the periphery.

These effects can control chronic heart failure and hypertension. And in the case of CHF "Carvedilol" - the drug of choice, because it is still an antioxidant. Therefore, the drug prevents the aggravation of atherosclerotic plaques.

Indications for the use of drugs group

All indications for the use of beta-blockers depend on the specific properties of the specific drug group. In nonselective blockers, indications are narrower, whereas selective blockers are more safe and can be used more widely. In general, the indications are common, although they are limited to the impossibility of using the medication in some patients. For non-selective drugs, the indications are as follows:

• Myocardial infarction in any periods, angina pectoris, rest, unstable angina ;
• Atrial fibrillation, normoform and tachyform;
• Sinus tachyarrhythmia with or without ventricular movement;
• Heart failure (chronic);
• Arterial hypertension ;
• Hyperthyroidism, thyrotoxicosis with or without a crisis;
• Pheochromocytoma with a crisis or for basic therapy of the disease in the preoperative period;
• migraine;
• Aortic aneurysm exfoliating;
• Alcohol or narcotic withdrawal syndrome.

Because of the safety of many of the group's drugs, especially the second and third generations, the list of beta-blocker drugs is often featured in the protocols for the treatment of heart disease and blood vessels. By frequency of application, they are almost identical with ACE inhibitors, which are used for the treatment of CHF and hypertension with and without metabolic syndrome . Together with diuretics, these two groups of drugs can increase life expectancy in chronic cardiac insufficiency.

Contraindications

Beta-blockers, like other drugs, have some contraindications. Moreover, since drugs affect the receptors, they are safer than the ACE inhibitors. General contraindications:

• Bronchial asthma, COPD;
• Bradyarrhythmia, syndrome of weakness of the sinus node;
• Atrial-ventricular blockade of the 2nd degree;
• Symptomatic hypotension;
• Pregnancy, child age;
• Decompensation of heart failure - CHF II B-III.

Also as a contraindication is an allergic reaction in response to a blocker. If a drug develops an allergy, then replacing the medicine with another will solve the problem.

Effects of clinical use of drugs

With angina pectoris preparations significantly reduce the frequency of anginal attacks and their strength, reduce the likelihood of developing acute coronary events. In CHF, treatment with beta-blockers with ACE inhibitors and two diuretics increases life expectancy. Drugs effectively control tachyarrhythmias and inhibit frequent ectopic rhythms on the ventricles. In total, the drugs help control the manifestation of any heart disease.

Conclusions about beta-blockers

"Carvedilol" and "Nebivolol" are the best beta-blockers. A list of drugs that show a predominant activity for beta receptors complements the list of essential therapeutically important drugs. Therefore, in clinical practice, either the third generation, namely Carvedilol or Nebivolol, or the drugs that are primarily selective for beta-1 receptors, such as Bisoprolol and Metoprolol, should be used. Even today, their use allows you to monitor hypertension and treat heart disease.