Beta blockers
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How they work
They block beta (β) receptors in the heart. This means that the heart slows down, and pumps less hard. Some types are selective, and only work on β1 receptors, reducing the side effects resulting from blockage of β2 receptors.
What are they used for
- Treating heart failure, since they make the heart work less hard.
- After someone has an MI, in order to prevent another one.
- Atrial fibrillation - alongside digoxin they control the heart rate.
- They are also used a bit to control hypertension, but not as much as they used to be.
- Other uses: treating anxiety, reducing eye pressure in glaucoma and preventing migraine.
Common types and dose
- Ramipril 2.5–5mg OD (max 10mg)
- Perindopril 2-4mg OD
Side effects
They can have a negative effect on renal function, and should never be used on a patient with bilateral renal artery stenosis. They also shouldn't be used with potassium sparing diuretics as this can cause hyperkalaemia.
Their key side effect is a characteristic dry tickling cough, that won't go away. If patients get this, and can't cope with it, you need to take them off the drug, probably best to try them on a angiotensin-II receptor antagonist...