Beta-blockers: list of drugs, indications for use

Drugs with important therapeutic effectsare widely used by specialists. They are used to treat cardiac diseases, which are the most frequent among 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

Chemical structure of class drugsnon-uniform and from it clinical effects do not depend. It is much more important to highlight the specificity for certain receptors and the 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 represented 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 (see the list of drugs, above) at different times were the main group of drugs that have been and are being used now 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 arerepresentatives of the first generation, that is, nonselective 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 compileda list of preparations of beta-blockers, the mechanism of action of which is associated with preferential blocking of receptors of the first type. They are characterized by a weak affinity for type 2 receptors, because 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 mostmodern beta-blockers. The list of preparations consists of Nebivolol, Carvedilol, Labetalol, Butcindolol, Celiprolol and others (see above). The most important from a clinical point of view are the following: Nebivolol and Carvedilol. The first predominantly blocks beta-1 receptors and stimulates NO release. This causes the expansion of blood vessels and a reduced risk of atherosclerotic plaques.

It is believed that beta-blockers are medications fromhypertension 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 peripheral vessels.

These effects allow you to monitor chronicheart 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-blockersdepend on the specific properties of the particular 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 drug in some patients. For non-selective drugs, the indications are as follows:

• myocardial infarction in any periods, angina of tension, 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;
• alcoholic or narcotic withdrawal syndrome.
  

Because of the safety of many drug groups,especially the second and third generations, the list of drugs beta-blockers is often featured in the protocols for the treatment of heart disease and blood vessels. On frequency of application they are practically 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 any drug develops an allergy, then replacing the medicine with another solves the problem.

Effects of clinical use of drugs

With stenocardia drugs significantly reducethe 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 bestbeta-blockers. A list of drugs that show a predominant activity for beta receptors complements the list of essential therapeutically important drugs. Therefore, in the clinical practice should be used or representatives of the third generation, namely "Carvedilol" or "Nebivolol", or mainly selective to beta-1 receptor medications: "Bisoprolol", "Metoprolol." Even today, their use makes it possible to control hypertension and treat heart disease.