Preparations with important therapeutic effects are widely used by specialists. They are used to treat cardiac diseases, which are the most common among other pathologies. These ailments more often than others lead to the death of patients. The drugs that are needed to treat these diseases are beta blockers. The list of class drugs, consisting of 4 sections, and their classification are presented below.
Beta blocker classification
The chemical structure of class drugs is heterogeneous and the clinical effects are independent of it. It is much more important to highlight specificity for certain receptors and affinity for them. The higher the specificity for beta-1 receptors, the less side effects of drugs. In this regard, it is rational to present a complete list of beta-blocker drugs.
The first generation of drugs:
- non-selective for beta receptors of the 1st and 2nd types: “Propranolol” and “Sotalol”, “Timolol” and “Oxprenolol”, “Nadolol”, “Penbutamol”.
Second generation:
- selective for type 1 beta receptors: 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 Karteolol, Labetalol and Butsindolol.
These beta-blockers (see the list of drugs above) at different times were the main group of drugs that have been and are now used for diseases of the vessels and heart. Many of them, mainly representatives of the second and third generations, are used today. Due to their pharmacological effects, it is possible to control the frequency of contractions of the heart and the conduct of an ectopic rhythm to the ventricles, to reduce the frequency of anginal attacks of angina pectoris.
Classification Explanation
The earliest medicines are representatives of the first generation, that is, non-selective beta-blockers. The list of drugs and preparations is presented above. These medicinal substances are able to block receptors of the 1st and 2nd types, having both a therapeutic effect and a side effect, which is expressed by bronchospasm. Therefore, they are contraindicated in COPD, bronchial asthma. The most important first-generation drugs are: Propranolol, Sotalol, Timolol.
Among the representatives of the second generation, a list of beta-blocker preparations has been compiled, the mechanism of action of which is associated with the predominant blocking of receptors of the first type. They are characterized by a weak affinity for type 2 receptors, therefore they rarely cause bronchospasm in patients with asthma and COPD. The most important drugs of the 2nd generation are Bisoprolol and Metoprolol, Atenolol.
3rd generation beta blockers
Representatives of the third generation are the most modern beta blockers. The list of drugs consists of Nebivolol, Carvedilol, Labetalol, Bucindolol, Celiprolol and others (see above). The most important from a clinical point of view are the following: Nebivolol and Carvedilol. The former predominantly blocks beta-1 receptors and stimulates the release of NO. This causes vasodilation and a decrease in the risk of developing atherosclerotic plaques.
Beta-blockers are believed to be a cure for hypertension and heart disease, while Nebivolol is a versatile drug that works well for both purposes. However, its cost 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 to reduce the frequency and strength of contractions of the heart, as well as expand the vessels of the periphery.
These effects allow you to control chronic heart failure and hypertension. Moreover, in the case of heart failure, “Carvedilol” is the drug of choice, because it is also an antioxidant. Because the tool prevents the aggravation of the development of atherosclerotic plaques.
Indications for the use of group drugs
All indications for the use of beta-blockers depend on certain properties of a particular group drug. Non-selective blockers have narrower readings, while selective ones are safer and can be used more widely. In general, indications are general, although they are limited by the inability to use the medicine in some patients. For non-selective drugs, the indications are as follows:
- myocardial infarction in any periods, angina pectoris, rest, unstable angina pectoris ;
- atrial fibrillation normoform and tachyform;
- sinus tachyarrhythmia with or without ventricles;
- heart failure (chronic);
- arterial hypertension ;
- hyperthyroidism, thyrotoxicosis with or without crisis;
- pheochromocytoma with a crisis or for the basic treatment of the disease in the preoperative period;
- migraine;
- aortic aneurysm stratified;
- alcohol or narcotic withdrawal syndrome.
Due to the safety of many drugs of the group, especially the second and third generations, the list of beta-blocker drugs is often featured in the protocols for the treatment of heart and vascular diseases. In frequency of use, they are almost identical with ACE inhibitors, which are used to treat heart failure and hypertension with and without metabolic syndrome . Together with diuretics, these two groups of drugs can increase life expectancy in chronic cardiac failure.
Contraindications
Beta blockers, like other drugs, have some contraindications. Moreover, since drugs act on receptors, they are safer than ACE inhibitors. General contraindications:
- bronchial asthma, COPD;
- bradyarrhythmia, sinus node weakness syndrome;
- atrial ventricular block II degree;
- symptomatic hypotension;
- pregnancy, children's age;
- decompensation of heart failure - CHF II B-III.
Also, an allergic reaction in response to taking a blocker appears as a contraindication. If an allergy develops on any drug, then replacing the drug with another solves the problem.
The effects of the clinical use of drugs
With angina pectoris, drugs significantly reduce the frequency of anginal attacks and their strength, reduce the likelihood of acute coronary events. In CHF, treatment with beta-blockers with ACE inhibitors and two diuretics increases life expectancy. Medications effectively control tachyarrhythmias and inhibit the frequent conduct of ectopic rhythms on the ventricles. In total, the funds help control the manifestations of any heart disease.
Beta Blocker Findings
Carvedilol and Nebivolol are the best beta blockers. The list of drugs that are predominantly active at beta receptors complements the list of essential therapeutically important drugs. Therefore, in clinical practice, either representatives of the third generation should be used, namely, Carvedilol or Nebivolol, or mainly drugs selective for beta-1 receptors: Bisoprolol, Metoprolol. Already today, their use allows you to control hypertension and treat heart disease.