Betablocker -Indications and contraindications

Betablocker -Indications and contraindications

Primarily used to treat cardiovascular diseases

Beta receptors

Beta receptors exist in three distinct forms:

  1. beta-1 (B1)
  2. beta-2 (B2)
  3. beta-3 (B3).

Beta-1 receptors – primarily in the heart

Beta-2 receptors- diverse location in many organ systems, control various aspects of metabolic activity and induce smooth muscle relaxation.

Beta-3 receptors induce the breakdown of fat cells and are less clinically relevant at present.

Betablocker -Indications and contraindications


  1. tachycardia,
  2. hypertension,
  3. myocardial infarction,
  4. congestive heart failure,
  5. cardiac arrhythmias,
  6. coronary artery disease,
  7. hyperthyroidism,
  8. essential tremor,
  9. aortic dissection,
  10. portal hypertension,
  11. glaucoma,
  12. migraine prophylaxis

Less common conditions such as –

  1. long QT syndrome
  2. hypertrophic obstructive cardiomyopathy

Heart failure

Specifically, the beta-blockers bisoprolol, carvedilol, and metoprolol succinate are the agents chosen.

Metoprolol tartrate is not indicated for heart failure and is instead used for other conditions such as atrial fibrillation.


  1. beta-blockers have been contraindicated in asthmatic patients.
  2.  cardio-selective beta-blockers, also known as beta-1 selective can be given
  3. Non-selective beta-blockers should not be used in patients with asthma.
  4. Acute or chronic bradycardia and/or hypotension have relatively contraindication to beta-blocker usage. 
  5. Patients diagnosed with long QT syndrome or who have had torsades de pointes in the past should not use the drug sotalol.
  6. Raynaud phenomenon- should avoid beta-blockers due to the risk of exacerbation.

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