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Beta Blockers Demystified | Action | Blood Pressure Meds | Nursing Pharmacology

Beta Blockers Demystified | Action | Blood Pressure Meds | Nursing Pharmacology


Created by nurses, for nurses. Hello everybody and welcome to the NRSNG youtube
channel. Today, we re going to talk about beta blockers. We re gonna talk about what
beta blockers are, why they re given and some of the side effects and nursing considerations
when giving beta blockers. Okay. So, if you want to download this presentation, and view
a special handout about beta blockers, you can go to NRSNG.com/BETA. What we ll have
on there is, we ll have some of the handouts from this presentation specifically discussing
what are beta blockers, why they re given and you can have that in a PDF file that you
can download free. So, go ahead and go to NRSNG.com/BETA and you ll be able to get that. Okay, when talking about beta blockers, first
and foremost, what we need to talk about is we need to talk about the sympathetic nervous
system. Okay, so we need to understand what exactly is being blocked. Right? Alright.
So, with beta blockers, so, there s sympathetic nervous system, what we have here is we have
several different actual receptor sites. So, with our sympathetic, there we go, sympathetic
nervous system or the SNS, what we re basically talking about is our fight or flight system,
okay? So, the sympathetic nervous system is the fight or flight response. And what we
have is we have several receptor sites in various locations throughout the body that
respond adrenaline and noradrenaline, and when they are stimulated by adrenaline and
noradrenaline, they have this fight or flight response. Okay, so that is our sympathetic
nervous system, SNS or fight or flight system. So, what we have here, is we have alpha receptors,
there are couples of those alpha 1, alpha 2. We also have beta receptors, Beta 1, 2,
and 3, we re not gonna talk about 3 at all. And then we also have dopaminergic receptors.
So, what happens is, when there is a stimulus, you know when a lion jumping out at you, a
test coming up, cute girl, cute boy, whatever, what happens is, this SNS would be stimulated
and you ll have that fight or flight response. And, that s going to stimulate alpha 1, alpha
2, beta 1, beta 2 receptors. Okay? So, that s what s gonna happen there. So, specifically, we need to talk about what
are beta receptors, okay? So, beta receptors. We have beta receptors, right? Okay. Okay,
so we have beta 1 and we have beta 2. Okay, so our beta 1 receptors are found primarily
in our heart. Okay, so we have these beta 1 receptors, and what they do is they are
basically in charge of heart rate, contractility, and conduction of the heart. Okay, so they
re gonna act on SA node and AV node and they re gonna affect heart rate, conduction
and the contraction in the heart. So, that
s our beta 1. The beta 2 receptors, on the other hand, are found primarily in the lungs.
What they re gonna deal with this is, they re gonna deal with like a brochodilation.
Okay, so, when the beta 1 receptors are stimulated, you re gonna see an increase heart rate, increased
conduction and increased contractility. When beta 2 receptors are stimulated, you re gonna
see bronchodilation. Okay? So, an easy way to remember this is beta 1, okay, you have
one heart, beta 2, you have two lungs. Okay, so, actions of the beta receptors include,
now this is specific to the heart. Actions of beta 1 receptors in the heart, they re
gonna increase cardiac output, they re gonna do that in a couple of ways. They re gonna
do that by increasing heart rate in SA node, that is referred to as Chronotropic effect.
So, chronotropic, chronological, think time, that s gonna increase heart rate. That s gonna
increase atrial contractility, so contractility is Inotropic effect. With that, just remember
that junction is a positive inotrope, so it s gonna increase that contractility. So, it
s also gonna increase the conduction automaticity of the AV node and it s gonna increase conduction
automaticity of ventricles. Okay. So, that s basically what beta blockers or beta receptors
are. Okay, so, when we re talking about beta blockers,
usually, we re referring to beta 1, that s what we re going to talk about today anyway,
we re gonna talking about beta 1 receptor blockers. Okay, now, you remember that beta
1 receptors are found in the heart, and we saw that they, what beta 1 receptors do when
they re acted upon is they increase heart rate, increase contractility, etc. And so,
what happens is, when we give beta 1 receptor blockers, what we re doing is, we re blocking
that action. Okay. So, we re stopping the central nervous system, that fight or flight
response, from being able to increase the heart rate and contractility and everything.
Cause that s really what s happening here. Okay, we re saying to the SNS, No. You cannot
stimulate those beta 1 receptors. Okay, so, that s really kinda what s happening. Now,
what are some of the beta blockers that you re gonna be giving? Okay. Some of the common beta blockers are gonna
be like propranolol and metoprolol, okay. And a good way to remember beta blockers are
these lol ending. Okay, so beta blockers are lol. Okay. Generally, that s what you re gonna
see. With beta 1 blockers, you re gonna see propranolol, metoprolol, and some few others
like esmolol that are given. So, you just really need to remember that they re gonna
end in lol. Okay. And so, what these are gonna do, is we also have cardioselective and non-cardioselective.
Okay. So, what s gonna happen here is, these are going to decrease our heart rate, and
they re gonna help kinda decrease that rate, that s kinda what we re looking for, is that
negative chronotrope effect there. Okay, so, now, a lot of people will ask won
t beta blockers decrease blood pressure? Okay, well, beta blockers are going to have an effect
in blood pressure, right? Because what we re doing is, we re decreasing our cardiac
output, okay, by decreasing our heart rate. So, as we decrease our cardiac output by decreasing
the heart rate, we are going to see a small drop in blood pressure, okay? We have less
volume going through, we re decreasing the rate, this is gonna be resulting to decrease
in blood pressure. But, you remember, that their primary effect is not on blood pressure.
So, while you re gonna see a minor decrease in blood pressure, that s not their goal.
Their goal is to decrease our heart rate. So, sometimes, it can be given to help decrease
blood pressure just a bit. But remember, we have our alpha 1 receptors which are found
in the vessels and their job is to basically constrict. So, what we ll usually do to decrease
blood pressure is we re gonna get an alpha receptor blocker, something like a atropine,
or something like that, that s gonna really directly affect the vessels. Okay. Beta blockers
are not affecting these alpha 1 receptors, they re working just on our beta receptors.
Okay? So, beta blockers are given, beta 1 receptors, they re decreasing cardiac output,
decreasing heart rate and that s really gonna be our goal, is to get our heart rate down.
So, what you re gonna do, you re obviously gonna be wanting to assess your patients pretty
often here, cause we, there s going to be a certain, usually there s parameters written
with the medication. It will be a Do not give if heart rate is less than 60. For example,
we don t wanna go too bradycardic and mess up the conduction system or anything like
that. So, you wanna monitor your patient s heart rate, you also wanna monitor their blood
pressure. A lot of times there will be parameters written to not give for systolic under 120
or so. So, you re gonna monitor these two things before and after giving the medication.
Some of the other side effects are that it can actually masked blood sugars. So, what
s gonna happen with Type I Diabetics is it can actually result to like a hypoglycemia
with Type I Diabetics. And with Type II Diabetics, it can actually cause these metabolic abnormalities
and lead to hyperglycemia, with Type II Diabetics. This is really metoprolol, specifically. Okay,
so let s just kinda write this out here. So, the side effects that you re really gonna
see, are gonna be, that you want them watch for, is gonna be brady, bradycardia, decreased
blood pressure, again, that s gonna happen as a result of decreased cardiac output and
heart rate, not necessarily from vasodilation or anything like that. You could also see
bronchoconstriction. Remember, it s not, so when we re giving these cardioselective beta
blockers that are really are proximes on the beta 1, you re not gonna see these too much
but you will wanna monitor for that bronchoconstriction. Okay? And then we re also gonna see alterations
in blood sugars. Okay. Bradycardia, blood pressure, bronchoconstrictions, blood sugars.
So, beta blockers, you have 4 B s for your side effects. Bradycardia, decreased blood
pressure, bronchoconstriction, blood sugars. And, now, we re talking again about beta 1
receptor blockers so we shouldn t, we ll see this as a result of what we re giving the
medication for. And this bronchoconstriction should not really happen with your cardioselective
beta blockers like metoprolol. Okay, so that s really just a basic introduction
to what beta blockers are. If you have questions, we invite you to contact us. You could contact
me, this is Jon. You can contact me at
[email protected] and be sure to go to NRSNG.com/BETA for handout about this lecture and handout
over beta blockers. We appreciate you watching and please leave us comments to let us know
how we can help you out. Thank you. Speaker: Visit us at NRSNG.com for disclaimer
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