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This pharmacology drug class review follows receptor signaling through cardiac conduction, calcium handling, blood pressure, and renin release. Learn why selectivity, formulation, clearance, drug interactions, and clinical evidence can make agents with similar effects on heart rate very different treatment choices.
Topics covered:
- Beta1 and beta2 receptors, SA and AV nodal effects, cardiac calcium handling, and the renal renin pathway.
- Stable HFrEF, hypertension, angina, and the evolving evidence after myocardial infarction.
- Atrial fibrillation rate control and comparisons among metoprolol, carvedilol, bisoprolol, propranolol, and other agents.
- Cardioselectivity, intrinsic sympathomimetic activity (ISA), CYP2D6 interactions, and drug availability or withdrawal.
- Adverse effects, contraindications, and monitoring—including bradycardia, bronchospasm, and hypoglycemia.
- Selected noncardiac uses, including essential tremor, migraine prevention, and the limited evidence for performance anxiety.
When we understand the why, we improve the how.
Chapter Table of Contents
00:00 - Introduction
02:45 - Beta-Blocker Classes, Agents & Formulations
09:20 - Clinical Indications & Evidence-Based Selection
15:30 - Heart Failure: Acute Effects vs. Long-Term Benefits
22:40 - Beta Receptor Locations & Selectivity
27:10 - Mechanisms: SA Node, AV Node & Cardiac Calcium
36:55 - Hemodynamics, Renin & Blood Pressure
43:00 - Pharmacokinetics, CYP2D6 & Drug Interactions
50:15 - Heart Failure Treatment & Dose Titration
56:45 - Hypertension, Angina & Post-MI Evidence
01:03:10 - Rate Control, Acute Care & Noncardiac Uses
01:14:59 - Adverse Effects, Contraindications & Clinical Takeaways
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Speaker:
Anthony Busti, MD, PharmD, MSc, FAHA, FNLA, is a licensed healthcare professional and medical educator with over 30 years of experience in clinical practice and academic teaching. He has trained and practiced as a nurse, pharmacist, and physician, bringing a uniquely comprehensive perspective to patient care and medical education.
Dr. Busti is dedicated to advancing evidence-based medicine and helping clinicians understand the underlying “why” behind clinical decisions to improve patient outcomes.
About This Channel:
This content is created by Anthony Busti, MD, PharmD, MSc, FAHA, FNLA, a board-certified physician with training at Johns Hopkins School of Medicine and University of Oxford and a medical educator for healthcare professionals and students. All material is based on current medical literature and evidence-based guidelines aligned with the principles of evidence-based medicine (EBM) and Evidence-Based Healthcare (EBHC).
Disclaimer:
This content is for educational purposes only and is not medical advice. It does not replace individualized evaluation, diagnosis, or treatment. Always seek the advice of a qualified health provider with questions about a medical condition and never delay care because of educational content.
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