Action: Blocks beta 1 & 2 stimulation. Results in decreased heart rate, myocardial contractility, blood pressure and myocardial oxygen demand.
Use: Treat hypertension, angina pectoris, pheochromocytoma, essential tremor, cyanosis in tetralogy of Fallot, arrhythmias (atrial, A-V nodal reentry, catecholamine induced) prevention of myocardial infarction, migraine headache, symptoms of hypertrophic subaortic stenosis. Treat Parkinson’s disease tremor, alcohol withdrawal, aggressive behavior, antipsychotic induced akathisia, bleeding esophageal varices, anxiety, schizophrenia, acute panic and gastric bleeding in portal hypertension.
Dental Considerations: Use local anesthesia with vasoconstrictors with caution, may cause hypertension followed by bradycardia. Dry mouth, paresthesias, blood dyscrasias, facial swelling and arthralgia.
Dental Drug Interaction: Hypotensive effect decreased by NSAIDs (use ok less than 3 days), penicillin, barbiturates and salicylates. Beta-blockers increase the effect of acetaminophen and anticoagulants.
Action: Blocks beta 1, reduces cardiac output by slowing heart rate and strength of contractility and thus reduces myocardial oxygen demand. Also may inhibit renin release by renal juxtaglomerular apparatus. Reduces spontaneous pacemaker firing and slows AV nodal conduction.
Use: Treat hypertension, angina pectoris, postmyocardial infarction, acute alcohol withdrawal, supraventricular and ventricular arrhythmias, and migraine headache prophylaxis.
Dental Considerations: Local anesthesia with vasoconstrictor ok. Dry mouth, blood dyscrasias, headache and sore throat.
Dental Drug Interaction: Decreased antihypertensive effect with long term NSAID (can give safely for three days) and barbiturates. May slow metabolism of lidocaine.