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| cardio:beta_blockers:start [2026/02/12 23:41] – andrew2393cns | cardio:beta_blockers:start [2026/02/12 23:47] (current) – [Mechanism of Action] andrew2393cns |
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| • Some provide additional vasodilation (α1 or NO-mediated) | • Some provide additional vasodilation (α1 or NO-mediated) |
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| Reference: [[autonomics:start]] | Reference: [[autonomics:start|Autonomic Receptors]] |
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| ===== Beta-Blocker Comparison Table ===== | ===== Beta-Blocker Comparison Table ===== |
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| ^ Drug ^ Generation ^ β1 Selective ^ α1 Blockade / Vasodilation ^ Lipophilic vs Hydrophilic ^ ISA ^ HFrEF Mortality Benefit ^ Common Clinical Uses ^ | ^ Drug ^ Generation ^ Beta-1 Selective ^ Alpha-1 / Vasodilation ^ Lipophilic vs Hydrophilic ^ HFrEF Mortality Benefit ^ Common Uses ^ |
| | |[[cardio:beta_blockers:propranolol|Propranolol]] | 1st | No | No | Lipophilic | No | Migraine, tremor, portal HTN | |
| | ★ [[cardio:beta_blockers:propranolol|Propranolol]] | 1st | No | No | Lipophilic | No | No | Migraine, tremor, portal HTN, anxiety | | | [[cardio:beta_blockers:sotalol|Sotalol]] | 1st | No | No | Hydrophilic | No | AF, ventricular arrhythmias | |
| | [[cardio:beta_blockers:nadolol|Nadolol]] | 1st | No | No | Hydrophilic | No | No | Portal HTN | | |[[cardio:beta_blockers:metoprolol|Metoprolol]] | 2nd | Yes | No | Lipophilic | Only Succinate | HTN, CAD, AF | |
| | [[cardio:beta_blockers:timolol|Timolol]] | 1st | No | No | Lipophilic | No | No | Glaucoma (topical) | | |[[cardio:beta_blockers:bisoprolol|Bisoprolol]] | 2nd | Yes | No | Moderate | Yes | HFrEF, HTN | |
| | [[cardio:beta_blockers:sotalol|Sotalol]] | 1st | No | No | Hydrophilic | No | No | AF, ventricular arrhythmias | | |[[cardio:beta_blockers:atenolol|Atenolol]] | 2nd | Yes | No | Hydrophilic | No | HTN (historical) | |
| | |[[cardio:beta_blockers:esmolol|Esmolol]] | 2nd | Yes | No | Hydrophilic | No | ICU rate control | |
| | ★ [[cardio:beta_blockers:metoprolol|Metoprolol]] | 2nd | Yes | No | Lipophilic | No | Only Succinate | HTN, CAD, AF rate control | | |[[cardio:beta_blockers:carvedilol|Carvedilol]] | 3rd | No | Yes (alpha-1) | Lipophilic | Yes | HFrEF, HTN | |
| | ★ [[cardio:beta_blockers:bisoprolol|Bisoprolol]] | 2nd | Yes | No | Moderate | No | Yes | HFrEF, HTN | | |[[cardio:beta_blockers:labetalol|Labetalol]] | 3rd | No | Yes (alpha-1) | Moderate | No | HTN emergency, pregnancy | |
| | ★ [[cardio:beta_blockers:atenolol|Atenolol]] | 2nd | Yes | No | Hydrophilic | No | No | HTN (historical use) | | |[[cardio:beta_blockers:nebivolol|Nebivolol]] | 3rd | Yes | Nitric Oxide-Mediated | Lipophilic | No | HTN | |
| | ★ [[cardio:beta_blockers:esmolol|Esmolol]] | 2nd | Yes | No | Hydrophilic | No | No | Acute ICU rate control | | |
| | [[cardio:beta_blockers:acebutolol|Acebutolol]] | 2nd | Yes | No | Moderate | Yes | No | Rarely used | | |
| | [[cardio:beta_blockers:pindolol|Pindolol]] | 2nd | Partial | No | Lipophilic | Yes | No | Rarely used | | |
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| | ★ [[cardio:beta_blockers:carvedilol|Carvedilol]] | 3rd | No | Yes (α1) | Lipophilic | No | Yes | HFrEF, HTN | | |
| | ★ [[cardio:beta_blockers:labetalol|Labetalol]] | 3rd | No | Yes (α1) | Moderate | No | No | HTN emergency, pregnancy | | |
| | ★ [[cardio:beta_blockers:nebivolol|Nebivolol]] | 3rd | Yes | NO-mediated | Lipophilic | No | No | HTN | | |
| | [[cardio:beta_blockers:bucindolol|Bucindolol]] | 3rd | No | Mild α1 | Lipophilic | No | No | Investigational/rare | | |
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| ===== Intrinsic Sympathomimetic Activity (ISA) ===== | ===== Intrinsic Sympathomimetic Activity (ISA) ===== |
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