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Metoprolol is a beta blocker, or an antagonist of the β-adrenergic receptors. It is specifically a selective antagonist of the β 1-adrenergic receptor and has no intrinsic sympathomimetic activity. [37] Metoprolol exerts its effects by blocking the action of certain neurotransmitters, specifically adrenaline and noradrenaline.
Regarding non-cardiac side effects, they can cause nausea, headache, fatigue, dry mouth, and dry eyes. [4] In rare cases, confusion , memory loss , and sexual dysfunction are reported. [ 12 ] Additionally, beta 1 blockers can mask hypoglycaemia-induced tachycardia in diabetic patients, potentially leading to hypoglycaemic unawareness and ...
However, the serotonin receptor antagonism has side effects such as weight gain and impaired movement. [11] Hence, alpha-2 blockers are not used clinically due to its extensive binding. Similar to the alpha-1 blocker, the alpha-2 family will also present the first-dose effect , but it is generally less pronounced compared with the alpha-1 blockers.
Figure 1: The chemical structure of dichloroisoprenaline or dichloroisoproterenol (), abbreviated DCI — the first β-blocker to be developed. β adrenergic receptor antagonists (also called beta-blockers or β-blockers) were initially developed in the 1960s, for the treatment of angina pectoris but are now also used for hypertension, congestive heart failure and certain arrhythmias. [1]
The choice between the drugs is to a large degree determined by the characteristics of the patient being prescribed for, the drugs' side effects, and cost. Most drugs have other uses; sometimes the presence of other symptoms can warrant the use of one particular antihypertensive. Examples include: Age can affect the choice of medications.
Antihypertensive agents comprise multiple classes of compounds that are intended to manage hypertension (high blood pressure). Antihypertensive therapy aims to maintain a blood pressure goal of <140/90 mmHg in all patients, as well as to prevent the progression or recurrence of cardiovascular diseases (CVD) in hypertensive patients with established CVD. [2]
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The primary application for phentolamine is for the control of hypertensive emergencies, most notably due to pheochromocytoma. [5]It also has usefulness in the treatment of cocaine-induced cardiovascular complications, where one would generally avoid β-blockers (e.g. metoprolol), as they can cause unopposed α-adrenergic mediated coronary vasoconstriction, worsening myocardial ischemia and ...