- Body system
- Cardiovascular
- Name stem
- -olol, -ilol, -alol
- Drug cards
- 3 in this guide
Drugs in this class
Other examples: Atenolol, Bisoprolol, Labetalol, Esmolol, Nebivolol.
How beta blockers work
Block beta-adrenergic receptors. Beta-1 blockade lowers heart rate, contractility and renin release. Cardioselective drugs (metoprolol, atenolol, bisoprolol) mostly spare the beta-2 receptors of the lungs; nonselective drugs (propranolol, nadolol) and carvedilol and labetalol also block beta-2, and carvedilol and labetalol block alpha-1 as well.
Uses
- Hypertension
- Angina
- Heart failure with reduced ejection fraction (metoprolol succinate, carvedilol, bisoprolol)
- After a myocardial infarction
- Rate control in atrial fibrillation
- Migraine prevention, essential tremor, symptoms of hyperthyroidism (propranolol)
Adverse effects
- Bradycardia and heart block
- Hypotension and dizziness
- Fatigue and exercise intolerance
- Bronchospasm (nonselective drugs)
- Masked signs of hypoglycemia
Nursing considerations
- Check the apical pulse for 1 full minute and the blood pressure before giving; hold and notify for values below the ordered parameters.
- Use with caution in asthma, COPD, diabetes and heart block; avoid nonselective drugs in asthma.
- Never stop suddenly: rebound tachycardia, hypertension and angina can occur.
Patient teaching
- Rise slowly.
- Diabetic patients: sweating may be the only warning sign of low blood sugar left; check glucose more often.
- Do not stop without talking to your provider.
Beta blockers NCLEX practice questions
Answer each question to see the rationale.
3 questions. Choose an answer to see the rationale.
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A patient's apical pulse is 52 before scheduled metoprolol. What should the nurse do first?
Show answer
Answer C: Hold the dose and notify the prescriber per the ordered parameters A heart rate below the ordered parameter (often 60) is a reason to hold a beta blocker and notify the prescriber. Never change a dose on your own.
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Which patient condition makes propranolol the most concerning choice?
Show answer
Answer B: Asthma Propranolol is nonselective and blocks beta-2 receptors in the lungs, which can cause bronchospasm in a patient with asthma.
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A patient with type 1 diabetes starts a beta blocker. Which teaching point is most important?
Show answer
Answer D: Tremor and fast heartbeat may not appear when blood sugar is low Beta blockade masks the adrenergic warning signs of hypoglycemia, such as tachycardia and tremor. Sweating usually persists.
Frequently asked questions
What are beta blockers?
Beta blockers slow the heart and lower blood pressure. The two nursing checks before every dose are the apical pulse and the blood pressure.
How do beta blockers work?
Block beta-adrenergic receptors. Beta-1 blockade lowers heart rate, contractility and renin release. Cardioselective drugs (metoprolol, atenolol, bisoprolol) mostly spare the beta-2 receptors of the lungs; nonselective drugs (propranolol, nadolol) and carvedilol and labetalol also block beta-2, and carvedilol and labetalol block alpha-1 as well.
What are examples of beta blockers?
Metoprolol, Propranolol, Carvedilol, Atenolol, Bisoprolol, Labetalol, Esmolol and Nebivolol.
What are the nursing considerations for beta blockers?
Check the apical pulse for 1 full minute and the blood pressure before giving; hold and notify for values below the ordered parameters. Use with caution in asthma, COPD, diabetes and heart block; avoid nonselective drugs in asthma.