beta blockers reow

Has my internet ever been slower? urgh i dont even know if it has the capacity to upload this (yes its being that slow) it has been an hour and it has only downloaded .6MBs lol. and no im not capped.

Anyways its friday. apparently its more effective to study classes as opposed to seperate drugs because itll be easier to learn more drugs at once and to remmeber side effects and MOA.

before i begin, might i also add that my download has been declared 'interupted'. the internet lord himself must be so exasperated he finds it useless for my internet to go on.

but anyways, ive decided to start easy with BETA-BLOCKERS. They are used for hyptertension and heart failure. lol those two lovebirds always go hand in hand. also for angina (stable and unstable), arrhythmias and glaucoma. on a related note, unstable angina is labelled for instances where angina attacks are longer than 15 mins, happen suddenly at rest or worsen. my oh my.
by blocking these beta receptors, catecholamines like adrenaline and noradrenaline can't exhibit their effects.
our beta blockers are hte drugs that end in 'lol' - definitely not a lol matter however (that was a bad joke). we have atenolol, bisoprolol, cavedilol, metoprolol, proponolol and sotalol just to name a few.
MOA
beta blockers block beta receptors (the name is a dead giveaway). its antihypertensive effect results from the decreased cardiac output without the increase in peripheral vascular resistence.its antianginal effect is due to a reduction of the left ventricular (pumps oxygenated blood to aorta) work which decreases the use of oxygen and heart rate + contractablity.
beta1 selective blockers have higher affinity for b1 receptors in heart and less so for b2 receptors in bronchi and peripheral blood vasculature (the fancy way of saying blood vessels, geez so fancy). the selective affinity however decreases with increasing doses. the b1 selective blockers are atenolol, bisoprolol, metoprolol and nebivolol. i remember it as NAB+M. all else the AMH has is non selective. (if only i knew this for my pharmacology exam)
carvedilol and labetalol also have some alpha1-blocking ability which provide extra arterial vasodilating action.
oxeprenalol and pindolol have some sympathomimetic activity. that means that in high doses, it exhibits effects of bronchodilation, increased blood pressure and pulse, but apparently the effects are 'limited' thank you mr wiki. they are basically partial agonists.
sotalol is particularly used for its antiarrthymetic effects.
PREEEEEEECAUTIONS
betablockers mask signs of hypoglycaemia  (tachycardia, tremor). it can also cause hypoglycaemia if it blocks B2 receptors cause B2 is responsible for stimulating glycogen breakdown in the liver so if it can't, obviously you get low blood glucose levels. B1 blockers mask tachycardia though, so always be careful in patients with diabetes!
drugs that cause bradycardia can also drastically decrease heart rate and cause hypotension
beta blockers may alsso impair peripheral circulation which can lead to Raynaud's phenomenom which is when the ends of fingers and toes discolour from lack of circulation.
in renal impairment, use a beta blocker that is predominantly eliminated hepatically. so avoid atenolol mate.
in hepatic impairment, use atenolol. otherwise, reduce dose.
if you've had surgery, there is an increased risk of bradycardia and hypotension, but even so you don't just suddenly stop taking it
ADVERSE EFFECTS
nausea (lol why does eveyrthing come with the risk of nausea), diarrhoea (this too), bronchospasm, dizziness.
carvedilol and labetalol (the mixed blockers) also pose a risk of orthostatic hypotension. dunno wth that is. hypotension in your foot? LOL. oh its the complete opposite. its wheen you get dizzy spells becuase your blood pressure drops when you stand up etc cause its all pooled down the bottom somewhat.
carvedilol also may cause oedema as a side effect. this carvedilol doesn't seem too sweet.
labetalol may also make your scalp tingle but its not common. lavetalol doesn't sound nice either.
COMPARISONSS
so the beta-1 selective ones would have less side effects because its cardioselective.
less lipid soluble ones (atenolol and bisprolol) are less likely to cross the BBB and give you nightmares (literally)
COUNSELLING
you may feel dizzy and tired when you first begin or increase your dose :) if you find this is so, do not drive or operate machinery. it will also help to get up slowly or try lying down to minimise the effect
don't stop taking this medication suddenly unless your doc gives you the okay. stopping abruptly may worsen angina, cause rebound hypertension etc. (the dose is usually reduced over at least 2 weeks. if you've used it for years though, it will be 4-6 weeks. if you've been taking it for heart failure, halve dose each week. )
with metoprolol  CR tablets, it is ok to break them , just don't crush or chew.

maaate, that was not easy.