What Are Selective Beta Blockers?

Selective beta blockers are medications that act primarily on beta-1 adrenoreceptors to control heart rate in patients with arrhythmias or high blood pressure. These drugs are part of a larger group of medications known collectively as beta blockers that can act on different beta adrenoreceptors and have different methods of action as well as an array of various side effects. Some examples of selective beta blockers include betataxolol, bisoprolol, and metoporolol.

These are second generation beta blockers. The first generation drugs, known as non-selective beta blockers, acted indiscriminately on beta-1 and beta-2 adrenoreceptors and carried a much higher risk of side effects. These drugs offer the control over heart rate and blood pressure that a doctor might want with beta blockers, with less of the risk of complications for the patient. A third generation of drugs is also available.

A patient on selective beta blockers should have a slower and more regular heart rate, and her heart will beat with less force. This lowers and stabilizes blood pressure. Patients become less reactive to stress hormones and experience fewer symptoms of stress, even in situations where their bodies produce compounds like adrenaline. A doctor may recommend the drug if the patient has an arrhythmia or a blood pressure problem. Selective beta blockers can also be useful in the management of patients recovering from myocardial infarction.

Unlike first generation drugs, these medications are less likely to cause bronchial restriction. The patient's airways will remain clear because the drugs do not act on the smooth muscle receptors in the trachea. For patients with asthma who cannot take non-selective beta blockers because they might experience an airway closure, these second generation drugs can be beneficial. Diabetic patients can also safely take selective beta blockers, as the medications do not lower blood sugar like their first generation counterparts.

Side effects like nausea and dizziness are still an issue with selective beta blockers. The drugs can also interact adversely with other medications, including herbal preparations that a patient may not think to disclose to a doctor. Before starting therapy, patients should discuss their medical and prescription history. If there are any contraindications, the doctor can address them or explore a different prescription if the patient cannot safely use these drugs. Patients should also make sure their doctors know they are using beta blockers when they accept prescriptions for additional medications, as a new prescription could clash.