Treatment with beta-blockers must begin “creeping in,” that is, with low doses that increase only slowly. The symptoms may also initially worsen. The therapeutic success of beta-blocker therapy usually only sets in after three months. Beta-blockers may therefore be administered only to patients who have been in a stable condition for some time.
Side effects of beta-blockers
Beta-blockers must not be given in certain heart arrhythmias, very slow heartbeat, extremely low blood pressure, asthma, and some other conditions.
Side effects include:
- Allergic skin reactions
- Fatigue, sleep disturbances, decreased lacrimation.
- Indigestion
- Fluctuating blood glucose levels
- Increased shortness of breath
- Potency disorders
The side effects usually disappear after discontinuation of the drug – in many patients also helps to switch to the preparation of another manufacturer. Therefore, patients should be in close contact with their treating physician during treatment with beta-blockers and report any complications directly to him.
Do not use for stress-related hypertension
However, in patients whose hypertension is primarily due to stress, treatment with beta-blockers could become problematic if the stress is not eliminated. Because this class of medication can lead to increased fatigue and decreased performance, a vicious cycle of “stress-high-pressure-medication-decreased performance-increased stress-…” can develop.
Young, dynamic people in particular run the risk of getting caught in this cycle. The reasons for high pressure must therefore be clarified before treatment is started and permanently checked during treatment.
Application of beta-blockers are possible in many ways
Beta-blockers can also be used for hyperthyroidism, cirrhosis of the liver with portal hypertension, circulatory disorders of the heart, and cardiac arrhythmias.
As the name suggests, beta-blockers block so-called beta-receptors, which are found in many different organs, resulting in the wide range of applications for beta-blockers:
- In hyperthyroidism, they are usually used only when an increased heart rate (tachycardia) is present. Various common single preparations with active ingredients such as metoprolol or bisoprolol can be used for this purpose. A special case is the so-called thyrotoxic crisis, a derailment of hyperthyroidism, which can be triggered, for example, by infections or iodine-containing contrast media. Then the beta-blocker propanolol is preferably used, which suppresses the production of active thyroid hormones and also acts against the symptoms of tremor and restlessness that occur in the clinical picture.
- In circulatory disorders of the heart – that is, coronary heart disease – and after heart attacks, beta-blockers are also used to reduce the heart rate. This is because the heart has to do less work as a result and oxygen consumption is reduced, which makes sense because the reduced blood flow supplies the heart with less oxygen. Here, many of the common beta-blockers can also be used as a single preparation.
- The same also applies to various forms of cardiac arrhythmia, in which the heart rate is increased (for example, atrial fibrillation).
- In liver cirrhosis with portal hypertension, on the other hand, propanolol is usually used, and carvedilol more rarely. These two beta-blockers lower the pressure in the portal vein by causing the vessel to dilate.
Beta-blockers as combination drugs.
Beta-blockers are in many cases as combination preparations on the market. Combination preparations usually combine beta-blockers with a dehydrating agent (hydrocholorothiazide; HCT) and are particularly useful in hypertension therapy because HCT becomes antihypertensive. They are also used in moderate to severe heart failure when water retention occurs.
