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Pharmacology case no 3.Beta Blocker

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Choice of Beta blocker in Atrial Fibrillation


1.What is Atrial Fibrillation?

Answer is:- Atrial fibrillation (AFib) is an irregular and often very rapid heart rhythm. An irregular heart rhythm is called an arrhythmia. AFib can lead to blood clots in the heart. The condition also increases the risk of stroke, heart failure and other heart-related complications.

During atrial fibrillation, the heart’s upper chambers — called the atria — beat chaotically and irregularly. They beat out of sync with the lower heart chambers, called the ventricles. For many people, AFib may have no symptoms. But AFib may cause a fast, pounding heartbeat, shortness of breath or light-headedness.

Episodes of atrial fibrillation may come and go, or they may be persistent. AFib itself usually isn’t life-threatening. But it’s a serious medical condition that needs proper treatment to prevent stroke. How to treat Atrial Fibrillation ?

Treatment for atrial fibrillation may include medicines, therapy to shock the heart back to a regular rhythm and procedures to block faulty heart signals.

A person with atrial fibrillation also may have a related heart rhythm problem called atrial flutter. The treatments for AFib and atrial flutter are similar.

2.What is the cause of Atrial fibrillation ?

Answer is :- Causes of atrial fibrillation is like the below point such as :- How to treat Atrial Fibrillation ?

Problems with the heart’s structure are the most common cause of atrial fibrillation (AFib).

Heart diseases and health problems that can cause AFib include:

  • A heart problem you’re born with, called a congenital heart defect.
  • A problem with the heart’s natural pacemaker, called sick sinus syndrome.
  • A sleep disorder called obstructive sleep apnea.
  • Heart attack.
  • Heart valve disease.
  • High blood pressure.
  • Lung diseases, including pneumonia.
  • Narrowed or blocked arteries, called coronary artery disease.
  • Thyroid disease such as an overactive thyroid.
  • Infections from viruses.

Heart surgery or stress due to surgery or sickness may also cause AFib. Some people who have atrial fibrillation have no known heart disease or heart damage.

Lifestyle habits that can trigger an AFib episode may include: How to treat Atrial Fibrillation ?

  • Drinking too much alcohol or caffeine.
  • Illegal drug use.
  • Smoking or using tobacco.
  • Taking medicines that contain stimulants, including cold and allergy medicines bought without a prescription.

3.What is the main symptoms of Atrial Fibrillation ?

Answer is:- Symptoms are :-

Symptoms of AFib may include:- How to treat Atrial Fibrillation ?

  • Feelings of a fast, fluttering or pounding heartbeat, called palpitations.
  • Chest pain.
  • Dizziness.
  • Fatigue.
  • Lightheadedness.
  • Reduced ability to exercise.
  • Shortness of breath.
  • Weakness.

Some people with atrial fibrillation (AFib) don’t notice any symptoms.

Atrial fibrillation may be:- How to treat Atrial Fibrillation ?

  • Occasional, also called paroxysmal atrial fibrillation. AFib symptoms come and go. The symptoms usually last for a few minutes to hours. Some people have symptoms for as long as a week. The episodes can happen repeatedly. Symptoms might go away on their own. Some people with occasional AFib need treatment.
  • Persistent. The irregular heartbeat is constant. The heart rhythm does not reset on its own. If symptoms occur, medical treatment is needed to correct the heart rhythm.
  • Long-standing persistent. This type of AFib is constant and lasts longer than 12 months. Medicines or a procedure are needed to correct the irregular heartbeat.
  • Permanent. In this type of atrial fibrillation, the irregular heart rhythm can’t be reset. Medicines are needed to control the heart rate and to prevent blood clots.
  •  

4.How can you prevent to Atrial Fibrillation ?

Answer is :- Prevention is AF:-

Healthy lifestyle choices can reduce the risk of heart disease and may prevent atrial fibrillation (AFib). Here are some basic heart-healthy tips:

  • Control high blood pressure, high cholesterol and diabetes.
  • Don’t smoke or use tobacco.
  • Eat a diet that’s low in salt and saturated fat.
  • Exercise at least 30 minutes a day on most days of the week unless your health care team says not to.
  • Get good sleep. Adults should aim for 7 to 9 hours daily.
  • Maintain a healthy weight.
  • Reduce and manage stress.
  •  

5.How to diagnosed in Atrial Fibrillation ?

Answer is:- Tests

Tests to diagnose atrial fibrillation (AFib) may include:

  • Blood tests. Blood tests are done to look for health conditions or substances that may affect the heart or heartbeat.
  • Electrocardiogram (ECG or EKG). This quick and painless test measures the electrical activity of the heart. Sticky patches called electrodes are placed on the chest and sometimes the arms and legs. Wires connect the electrodes to a computer, which prints or displays the test results. An ECG can show the heart rhythm and how slow or fast the heart is beating. It’s the main test for diagnosing atrial fibrillation.
  • Holter monitor. This small, portable ECG device records the heart’s activity. It’s worn for a day or two while you do your regular activities.
  • Event recorder. This device is like a Holter monitor, but it records only at certain times for a few minutes at a time. It’s typically worn for about 30 days. You usually push a button when you feel symptoms. Some devices automatically record when an irregular heart rhythm is detected.
  • Implantable loop recorder. This device records the heartbeat continuously for up to three years. It’s also called a cardiac event recorder. The device shows how the heart is beating while you do your daily activities. It may be used to see how often you have an AFib episode. Sometimes it’s used to find rare episodes of AFib in those at high risk of the heart problem. For example, you may need one if you’ve had an unexplained stroke.
  • Echocardiogram. Sound waves are used to create images of the beating heart. This test can show how blood flows through the heart and heart valves.
  • Exercise stress tests. These tests often involve walking on a treadmill or pedaling a stationary bike while the heart is monitored. The tests show how the heart reacts to exercise. If you can’t exercise, you may be given medicine that increases the heart rate like exercise does. Sometimes echocardiogram is done during a stress test.
  • Chest X-ray. A chest X-ray shows the condition of the lungs and heart.

6.How to treatment of Atrial Fibrillation ?

Answer is:-

Treatment or Medication are :- Medicines that may be used include:

  • Beta blockers. These medicines help slow the heart rate.
  • Tablet1:Tenoloc 50mg (AS A Atenolol Beta-adrenoceptor blocking drugs, Beta-blockers).
Indications of drug Tenoloc:-

Tenoloc is indicated- How to treat Atrial Fibrillation ?

  • In the management of hypertension. It may be used alone or concomitantly with other antihypertensive agents, particularly with a thiazide-type diuretic.
  • For the long-term management of patients with angina pectoris.
  • In the management of hemodynamically stable patients with defnite or suspected acute myocardial infarction to reduce cardiovascular mortality.
Side Effects of Tenoloc (Beta Blocker):-

In a series of investigations in the treatment of acute myocardial infarction, bradycardia and hypotension occurred more commonly, as expected for any beta blocker. In addition, a variety of adverse efects has been reported with other beta-adrenergic blocking agents, and may be considered potential adverse efects of Tenoloc.

  • Hematologic: Agranulocytosis.
  • Allergic: Fever, combined with aching and sore throat, laryngospasm, and respiratory distress.
  • Central Nervous System: Reversible mental depression progressing to catatonia; an acute reversible syndrome characterized by disorientation of time and place; short term memory loss; emotional lability with slightly clouded sensorium; and, decreased performance on neuropsychometrics.
  • Gastrointestinal: Mesenteric arterial thrombosis, ischemic colitis.
  • Miscellaneous: There have been reports of skin rashes and/or dry eyes associated with the use of beta-adrenergic blocking drugs. Discontinuance of the drug should be considered if any such reaction is not otherwise explicable. Patients should be closely monitored following cessation of therapy.
  • Other: Erythematous rash
  •  
  •  
  • Calcium channel blockers. These medicines control the heart rate but may need to be avoided by those who have heart failure or low blood pressure.
  • Digoxin. This medicine may control the heart rate at rest, but not as well during activity. Most people need additional or alternative medicines, such as calcium channel blockers or beta blockers.
  • Medicines to control the heart rate and rhythm. Also called anti-arrhythmics, this type of medicine is used sparingly. They tend to have more side effects than other medicines to control the heart rate.
  • Blood thinners. Also called anticoagulants, these medicines help prevent blood clots and reduce the risk of stroke. Blood thinners include warfarin (Jantoven), apixaban (Eliquis), dabigatran (Pradaxa), edoxaban (Savaysa) and rivaroxaban (Xarelto). If you take warfarin, you’ll need to have regular blood tests to monitor the medicine’s effects.
Cardioversion therapy

If atrial fibrillation symptoms are bothersome or if this is the first AFib episode, a doctor may try to reset the heart rhythm using a procedure called cardioversion.

Cardioversion can be done in two ways:

  • Electrical cardioversion. This method to reset the heart rhythm is done by sending electric shocks to the heart through paddles or patches placed on the chest.
  • Drug cardioversion. Medicines given through an IV or by mouth are used to reset the heart rhythm.

Cardioversion is usually done in a hospital as a scheduled procedure. However, it may be done in emergency situations. If it’s scheduled, a blood thinner such as warfarin (Jantoven) may need to be taken for a few weeks before the procedure. The medicine reduces the risk of blood clots and strokes.

After electrical cardioversion, medicines to control the heart rhythm may be needed for life to prevent future episodes of atrial fibrillation. Even with medicine, AFib could return.

Kono Rogi I mean PT er jodi sudu matro AF thake tobe tar first choice thake choice of Atenolol Beta blocker tablet1.Tenoloc 50 mg (AS A Atenolol Beta-adrenoceptor blocking drugs, Beta-blockers).
Keno tader choice thake ai medicine ta because of
1.daily once dose tai.
2.kom dam
  • Kintu jodi pt er only AF +History of IHD(ischemic heart disease). Kono heart failure er history na thake tobe oisob pt ke diben
  • 1.Metoprolol (Standard dose) Othoba
  • 2.Propranolol or Atenolol.
1.Metoprolol:-

Tablet2.Betaloc 50 mg (AS A Metoprolol Tartrate AS A selective beta1-blocker).

Indications OF Metoprolol:-

ln the management of hypertension and angina pectoris. Cardiac arrhythmias, especially supraventricular tachyarrhythmias. Adjunct to the treatment of hyperthyroidism. Early intervention with Betaloc in acute myocardial infarction reduces infarct size and the incidence of ventricular fibrillation. Pain relief may also decrease the need for opiate analgesics. Betaloc has been shown to reduce mortality when administered to patients with acute myocardial infarction.

Side Effects Of Metoprolol:-

Tiredness, dizziness, depression, diarrhea, itching or rash, shortness of breath, slow heart rate, mental confusion, headache, somnolence, nightmares, insomnia, dyspnea, Nausea, dry mouth, gastric pain, constipation, flatulence, digestive tract disorders, heartburn, pruritus, musculoskeletal pain, blurred vision, decreased libido, and tinnitus have also been reported, intensification of AV block.

2.Propranolol :-

Tablet2.Propranol 10 mg (AS A Propranolol Hydrocholoride AS A Beta-adrenoceptor blocking drugs, Beta-blockers Propranolol Hydrochloride is a B-adrenergic receptor blocking drug )

Indications OF Propranol drug:-

Propranol is indicated in: How to treat Atrial Fibrillation ?

  • Essential hypertension
  • Angina pectoris
  • Cardiac arrhythmia
  • Thyrotoxicosis
  • Anxiety
  • Prophylaxis of migraine, etc.
  •  

OR 3.Atenolol:– Tablet1:Tenoloc 50mg (AS A Atenolol Beta-adrenoceptor blocking drugs, Beta-blockers).

Indications of drug Tenoloc:-(Beta Blocker)

Tenoloc is indicated-

  • In the management of hypertension. It may be used alone or concomitantly with other antihypertensive agents, particularly with a thiazide-type diuretic.
  • For the long-term management of patients with angina pectoris.
  • In the management of hemodynamically stable patients with defnite or suspected acute myocardial infarction to reduce cardiovascular mortality.
Side Effects of Tenoloc (Beta Blocker):-

In a series of investigations in the treatment of acute myocardial infarction, bradycardia and hypotension occurred more commonly, as expected for any beta blocker. In addition, a variety of adverse efects has been reported with other beta-adrenergic blocking agents, and may be considered potential adverse efects of Tenoloc.

  • Hematologic: Agranulocytosis.
  • Allergic: Fever, combined with aching and sore throat, laryngospasm, and respiratory distress.
  • Central Nervous System: Reversible mental depression progressing to catatonia; an acute reversible syndrome characterized by disorientation of time and place; short term memory loss; emotional lability with slightly clouded sensorium; and, decreased performance on neuropsychometrics.
  • Gastrointestinal: Mesenteric arterial thrombosis, ischemic colitis.
  • Miscellaneous: There have been reports of skin rashes and/or dry eyes associated with the use of beta-adrenergic blocking drugs. Discontinuance of the drug should be considered if any such reaction is not otherwise explicable. Patients should be closely monitored following cessation of therapy.
  • Other: Erythematous rash
  •  
Ar jodi rogi er Heart Failure er History thake tobe tar jonnho best choice of medicine hose
Hoi Bisoprolol OR Carvedilol OR Nebivolol.

4.Bisoprolol :- How to treat Atrial Fibrillation ?

Tablet1.Ancor 10 mg (AS A Bisoprolol Hemifumarate AS A  Anti adrenergic agent (Beta blockers), Beta-adrenoceptor blocking drugs, Beta-blockers Bisoprolol Hemifumarate is the most selective ß1 blocker.).

Indications Of Ancor drug(Bisoprolol):-

Ancor is indicated in-

  • Hypertension
  • Angina
  • Moderate to severe heart failure

Ancor is not recommended for the emergency treatment of hypertensive crises.

Side Effects of Ancor drug (Bisoprolol):- How to treat Atrial Fibrillation ?

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect. Fatigue, dizziness, headache, disturbances of the gut such as nausea, vomiting, diarrhea, constipation or abdominal pain. Cold or numb extremities, e.g; hands and feet. Muscle weakness or cramps. Slower than normal heart breathing difficulties due to a narrowing of the airways (bronchospasm) in people with asthma or COPD.

5.Carvedilol:-
Tablet1:- Carvista 12.5 Mg AS A Carvedilol (AS A Alpha adrenoceptor blocking drugs, Beta-adrenoceptor blocking drugs, Beta-blockers Carvedilol is a cardiovascular drug whose main pharmacological action is non-selective antagonism of β-adrenergic receptors ).
Indications of Carvista drug (Carvedilol):-

Carvista is indicated for the treatment of mild, moderate or severe heart failure of ischemic or cardiomyopathic origin, in conjunction with digitalis, diuretics and ACE inhibitor, to reduce the progression of disease as evidenced by cardiovascular death, cardiovascular hospitalization, or the need to adjust other heart failure medications. Carvista may be used in patients unable to tolerate an ACE inhibitor. Carvista may be used in patients who are not receiving digitalis, hydralazine or nitrate therapy.

Side Effects of Carvista drug(Carvedilol):-

Postural hypotension, dizziness, headache, fatigue, gastro-intestinal disturbances, bradycardia; occasionally diminished peripheral circulation, peripheral oedema and painful extremities, dry mouth, dry eyes, eye irritation or disturbed vision, impotence, disturbances of micturition, influenza-like symptoms, rarely angina, AV block, exacerbation of intermittent claudication or Raynaud’s phenomenon, allergic skin reactions, exacerbation of psoriasis, nasal stuffiness, wheezing, depressed mood, sleep disturbances, paresthesia, heart failure, changes in liver enzymes, thrombocytopenia, leukopenia are also reported..

6.Nebivolol:- How to treat Atrial Fibrillation ?

Tablet2:-Nebipro 5 mg AS A Nebivolol Hydrochloride AS A Beta-adrenoceptor blocking drugs, Beta-blockers (AS A Nebivolol is a β adrenergic receptor blocking agent. Nebivolol inhibits both β1 and β1 adrenergic receptors.)

Indications OF Nebipro Drug (Nebivolol):- How to treat Atrial Fibrillation ?

Nebipro is indicated in- How to treat Atrial Fibrillation ?

  • Hypertension
  • Treatment of essential hypertension
  • Chronic heart failure (CHF)
  • Treatment of stable mild and moderate chronic heart failure in addition to standard therapies in elderly patients.
Side Effects OF Nebipro drug (Nebivolol):-

Headache, nausea and bradycardia.

  •  

End of article.

Artical made by Raiyyan Tahsan date:30-10-24 Wednesday time 8:30AM.

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