β-adrenergic receptor blockers: Adverse effects and drug interactions

Abstract

Adverse effects of β-adrenergic receptor blocking drugs can be divided into two categories: 1) those that result from known pharmacological consequences of β-adrenergic receptor blockade; and 2) other reactions that do not appear to result from β-adrenergic receptor blockade. Adverse effects of the first type include bronchospasm, heart failure, prolonged hypoglycemia, bradycardia, heart block, intermittent claudication, and Raynaud's phenomenon. Neurological reactions include depression, fatigue, and nightmares. It is not yet proven whether the β 1 -selective adrenergic blockers or those with partial agonist activity reduce the overall frequency of adverse reactions seen with propranolol. Patient age does not appear, in itself, to be associated with more β-blocker side effects. Side effects of the second category are rare. They include an unusual oculomucocutaneous reaction and the possibility of oncogenesis. There are also many drugs that interact with β-blockers, which may increase toxicity. Finally, there are specific patient characteristics where one β-blocker may be more effective and safer than another © 1988 American Heart Association, Inc.