Beta-1 Blockers

β1 blockers inhibit β1 receptors.  These medications are primarily used for the treatment of cardiovascular conditions including myocardial infarction, heart failure, and hypertension.  Fatigue and sexual side effects can be problematic with patient adherence.  

Class Drugs

• Atenolol

• Betaxolol

• Bisoprolol

• Esmolol

• Metoprolol

• Nebivolol

Class Mechanism of Action

• Preferentially blocks β1 receptors.

Class Application

Hypertension

• Negative inotrope and chronotrope

Angina

• Decreased myocardial oxygen consumption

Chronic Heart Failure

• Decreased effect of adrenergic drive on heart

• Decreases heart rate.

• Class II Antiarrhythmic

Myocardial infarction

• Decreased myocardial oxygen consumption

• Class II Antiarrhythmic

• Blunts response to catecholamines.

Adverse Effects

• Bronchoconstriction (less pronounced than non-selective beta blockers, but caution should be exercised in COPD/asthma)

• Arrhythmias

• Depression

• Dizziness

• Fatigue

• Sexual dysfunction

Drug Table

Drug Name	Application	Comments	Image
Atenolol	Angina; Hypertension; Myocardial Infarction		"10 of Hearts" and "Lollipop"
Betaxolol	Chronic open angle glaucoma	Reduces production of aqueous humor	"Bee" and "Tax" and "Lollipop"
Bisoprolol	Hypertension; Heart failure		"Bison" and "Lollipop"
Esmolol	Tachycardias; Hypertensive Emergency	IV infusion that is rapidly metabolized; Used to lower blood pressure and heart rate in setting of aortic dissection	"Escalade" and "Lollipop"
Metoprolol	Angina; Hypertension; Myocardial Infarction; Congestive Heart Failure	Widely used medication available in oral and IV formulations	"Mr. Met" and "Lollipop"
Nebivolol	Hypertension	Also stimulates release of nitrous oxide, which results in vasodilation	"Nebraska" and "Lollipop"