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Bisoprolol

Beta blocker

Table of contents

What is bisoprolol used for?

Bisoprolol is a beta blocker that blocks the effects of hormones on the heart and blood vessels.

It treats high blood pressure, heart failure and chest pain. 

What is the mechanism of action of bisoprolol?

Beta-blockers stop hormones from attaching to beta receptors. Beta receptors can be found in the heart, lungs, kidneys and blood vessels.

When hormones attach to beta receptors, the heart beats faster, lungs breathe in more air and blood vessels get narrower.

By blocking beta receptors, this 
slows the heart rate, lowers blood pressure, and helps the heart pump better.

What are the contraindications of bisoprolol?

In people who already have low blood pressure, beta blockers 
can cause dangerously low blood pressure, dizziness, and fainting.

In uncontrolled heart failure, the heart can't pump well. Beta blockers can make this worse, causing fluid buildup and worsening symptoms.

Asthma narrows the airways. Non-selective beta blockers in particular can make them even narrower. This can cause breathing problems and asthma attacks.

Important bisoprolol prescribing safety information.

Bisoprolol can mask the symptoms of low blood sugar (hypoglycaemia) and affect the body’s response to hypoglycaemia.

Bisoprolol can hide overactive thyroid (hyperthyroidism) symptoms by slowing heart rate and metabolism.

Starting with a low dose helps to lower the risk of side effects. The dose can then be adjusted to reach 

 best results safely. 

Bisoprolol patient counselling advice.

Advise patients not to stop taking the medicine suddenly, as it can harm their heart. Encourage patients to discuss with their doctor before stopping or changing the dose of bisoprolol.

Warn patients they may feel dizzy when starting or raising the dose. Advise patients to be careful when standing or changing positions to prevent falls.

Recommend maintaining a healthy lifestyle that includes staying well-hydrated, a balanced diet with adequate sleep and exercise.

References

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2. Dungan, Kathleen, et al. “Effect of Beta Blocker Use and Type on Hypoglycemia Risk among Hospitalized Insulin Requiring Patients.” Cardiovascular Diabetology, vol. 18, no. 1, 27 Nov. 2019, https://doi.org/10.1186/s12933-019-0967-1. Link

3. Jones, D K, and S Solomon. “Thyrotoxic Crisis Masked by Treatment with Beta-Blockers.” BMJ, vol. 283, no. 6292, 5 Sept. 1981, pp. 659–659, https://doi.org/10.1136/bmj.283.6292.659. Link

4. Lichtenstein, Alice H., et al. “2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement from the American Heart Association.” Circulation, vol. 144, no. 23, 2 Nov. 2021, https://doi.org/10.1161/cir.0000000000001031. Link

5. Morales, Daniel R., et al. “Respiratory Effect of Beta-Blockers in People with Asthma and Cardiovascular Disease: Population-Based Nested Case Control Study.” BMC Medicine, vol. 15, no. 1, 27 Jan. 2017, https://doi.org/10.1186/s12916-017-0781-0. Link

6. Motiejunaite, Justina, et al. “Adrenergic Receptors and Cardiovascular Effects of Catecholamines.” Annales D’Endocrinologie, vol. 82, no. 3-4, Mar. 2020, pubmed.ncbi.nlm.nih.gov/32473788/, https://doi.org/10.1016/j.ando.2020.03.012. Link

7. Naik, S. D., and Ronald S. Freudenberger. “Beta-Blocker Contraindications: Are There Patients or Situations Where Use Is Inappropriate?” Current Heart Failure Reports, vol. 4, no. 2, June 2007, pp. 93–98, https://doi.org/10.1007/s11897-007-0006-5. Link

8. Prichard, B. N. C. “Bisoprolol: A New Beta-Adrenoceptor Blocking Drug.” European Heart Journal, vol. 8, no. suppl_M, 1 Dec. 1987, pp. 121–129, academic.oup.com/eurheartj/article-abstract/8/suppl_M/121/607130, https://doi.org/10.1093/eurheartj/8.suppl_M.121. Link