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Page: Adverse Effects
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Adverse drug reactions (ADRs) associated with the use of beta blockers include: nausea, diarrhoea, bronchospasm, dyspnoea, cold extremities, exacerbation of Raynaud's syndrome, bradycardia, hypotension, heart failure, heart block, fatigue, dizziness, abnormal vision, decreased concentration, hallucinations, insomnia, nightmares, depression, sexual dysfunction, erectile dysfunction and/or alteration of glucose and lipid metabolism. Mixed ?1/?-antagonist therapy is also commonly associated with orthostatic hypotension. Carvedilol therapy is commonly associated with oedema. (Rossi, 2006)
Central nervous system (CNS) adverse effects (hallucinations, insomnia, nightmares, depression) are more common in agents with greater lipid solubility, which are able to cross the blood-brain barrier into the CNS. Similarly, CNS adverse effects are less common in agents with greater aqueous solubility (listed below).
Adverse effects associated with ?2-adrenergic receptor antagonist activity (bronchospasm, peripheral vasoconstriction, alteration of glucose and lipid metabolism) are less common with ?1-selective (often termed "cardioselective") agents, however receptor selectivity diminishes at higher doses.
A 2007 study (W.J. Elliott, P. Meyer, The Lancet, Jan 20, 2007) revealed that diuretics and beta-blockers used for hypertension increase a patient's risk of developing diabetes. ACE inhibitors and Angiotension Receptor Blockers (ARBs) actually decrease the risk of diabetes. Clinical guidelines in Great Britain, but not in the United States, call for avoiding diuretics and beta-blockers as first-line treatment of hypertension due to the risk of diabetes.
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