Beta blockers
Beta-adrenoceptor signalling and how selectivity, lipophilicity, intrinsic sympathomimetic activity and extra actions (alpha blockade, sodium and potassium channel block) explain the uses, adverse effects and overdose features of beta blockers.
Tier 2Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- β1 (heart, juxtaglomerular cells), β2 (bronchial and vascular smooth muscle, liver, skeletal muscle) and β3 (fat, bladder) receptors all couple to Gs, raising cAMP.
- Blocking cardiac β1 slows the heart, lowers contractility and AV conduction, and lowers renin.
- Individual drugs differ in selectivity, lipophilicity, ISA, route of clearance and extra actions. Those differences are what Paper 1 examines.
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Sources
- Therapeutic Guidelines: CardiovascularAU/NZTherapeutic Guidelines Limited, 2026
- Australian Medicines HandbookAU/NZAustralian Medicines Handbook Pty Ltd, 2026
- Køber L, Adamo M et al. 2026 ESC Guidelines for the management of heart failure. Eur Heart J 2026. doi:10.1093/eurheartj/ehag100European Heart Journal (ESC), 2026
- Yndigegn T et al. Beta-blockers after myocardial infarction and preserved ejection fraction (REDUCE-AMI). N Engl J Med 2024;390:1372-81New England Journal of Medicine, 2024
- Munkhaugen J et al. Beta-blockers after myocardial infarction in patients without heart failure (BETAMI-DANBLOCK). N Engl J Med 2025;393:1901-11New England Journal of Medicine, 2025
- Ibanez B et al. Beta-blockers after myocardial infarction without reduced ejection fraction (REBOOT). N Engl J Med 2025;393:1889-1900New England Journal of Medicine, 2025
- Kristensen AMD, Rossello X, Atar D et al. Beta-blockers after myocardial infarction with normal ejection fraction (individual-patient meta-analysis). N Engl J Med 2026;394:540-50New England Journal of Medicine, 2026
- Rossello X, Prescott EIB, Kristensen AMD et al. Beta blockers after myocardial infarction with mildly reduced ejection fraction: an individual patient data meta-analysis. Lancet 2025;406:1128-37The Lancet, 2025
- Flather MD, Shibata MC, Coats AJS et al. Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS). Eur Heart J 2005;26:215-25European Heart Journal (ESC), 2005
- MERIT-HF Study Group. Effect of metoprolol CR/XL in chronic heart failure (MERIT-HF). Lancet 1999;353:2001-7The Lancet, 1999
- CIBIS-II Investigators. The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II). Lancet 1999;353:9-13The Lancet, 1999
- Last updated
- 14 November 2026
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