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Beta blockers' inhibition on epinephrine's effect can somewhat exacerbate hypoglycemia by interfering with glycogenolysis and mask signs of hypoglycemia such as tachycardia, palpitations, diaphoresis, and tremors. Diligent blood glucose level monitoring is necessary for a patient with diabetes mellitus on beta blockers.
Additionally, beta 1 blockers can affect beta 2 receptors, particularly at high doses, and hence should not be administered to patients with peripheral vascular disease or diabetes mellitus as they may cause vasoconstriction or a delayed hypoglycaemic response, respectively. [4]
Beta-blockers with intrinsic sympathomimetic activity: acebutolol, pindolol; Some common side effects include increased airway resistance for non-selective beta-blockers, exacerbation of peripheral vascular diseases, and hypotension [15] Beta-blockers are contraindicated in patients with second- or third-degree atrioventricular block.
The combination of beta blockers and antihypertensive drugs will work on different mechanism to lower blood pressure. [17] For example, the co-administration of beta-1 blocker atenolol and ACE inhibitor lisinopril could produce a 50% larger reduction in blood pressure than using either drug alone. [18]
Diabetes medications have four main mechanisms of action: [citation needed] Insulin sensitization: Increased sensitivity of insulin receptors on cells leading to decreased insulin resistance, and higher effects of insulin on blood glucose levels. Stimulation of beta cells: This stimulation increases insulin secretion from beta cells of pancreas.
These drugs are often first-line treatment for the target diseases and are effective in tackling the symptoms. An example of the target disease is ischemic heart disease. Some examples of commonly prescribed drugs for this disease are beta-blockers, calcium-channel blockers and nitrates.
Other side effects include masking the symptoms of low blood sugar in those with diabetes. [3] Use is not recommended in those with asthma, uncompensated heart failure, or chronic obstructive pulmonary disease (COPD). [3] It is unclear if use during pregnancy is safe for the fetus. [6] Timolol is a non-selective beta blocker. [3]
Propranolol, like other beta-blockers, is classified as pregnancy category C in the United States and ADEC category C in Australia. β-blocking agents in general reduce perfusion of the placenta, which may lead to adverse outcomes for the neonate, including lung or heart complications, or premature birth.
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