Nonselective Beta Blockers

Nonselective beta blockers inhibit β1 and β2 receptors.  Propranolol is the most widely used oral medication in this class. Timolol is frequently used in the treatment of chronic open angle glaucoma and functions by decreasing aqueous humor production.

Class Drugs

• Propranolol

• Nadolol

• Timolol

Class Mechanism of Action

• Blocks beta-1 and beta-2 receptors

Class Application

Hypertension

• Negative inotrope and chronotrope (beta-1 effects)

• Inhibits renin release from the kidney.

• Decreased sympathetic discharge from CNS

• Decreased total peripheral vascular resistance

Angina

• Decreased myocardial oxygen consumption (beta-1)

Myocardial infarction

• Decreased myocardial oxygen consumption (beta-1)

• Antiarrhythmic

• Blunts response to catecholamines.

Migraine Prophylaxis

• Penetrates CNS well and decreases migraine episodes.

Thyroid Storm & Hyperthyroidism

• Blunts response to catecholamines in high thyroid states.

Adverse Effects

• Bronchoconstriction (contraindicated in asthma or COPD)

• Arrhythmias

• Sexual dysfunction

• Depression

• Dizziness

• Fatigue

• Hypoglycemia

Decreased glucagon secretion

• Beta blockade also masks symptoms of hypoglycemia.

Drug Table

Drug Name	Application	Comments	Image
Propranolol	Hypertension; Angina; Myocardial Infarction; Migraine prophylaxis		"Propane tank" and "lollipop"
Nadolol	Angina; Hypertension	Long duration of action	"Sodium" and "Lollipop"
Timolol	Chronic open angle glaucoma	Reduces production of aqueous humor	"Tiny Tim" and "Lollipop"