There are also two types of beta-adrenergic blockers: selective and non-
selective. For example, metoprolol tartrate (Lopressor) is a selective beta-
adrenergic blocker that blocks beta 1 receptors to decrease pulse rate and decrease
blood pressure. Propranolol NCl (Inderal) is a non-selective beta-adrenergic
blockerthat blocks both beta 1 and beta 2 receptors resulting in a slower heart
rate, decreased cardiac output, and lower blood pressure.(^286) CHAPTER 15 Nervous System Drugs
Other Beta Blockers
Doxazosin mesylate Mild to moderate hypertension; PO: 1 mg/d; titrate dose up to
(Cardura) alpha 1 maximum of 16 mg/d; maintenance 4–8 mg/day. Pregnancy
category C; PB 95%; half life 3 h.
Carvedilol (Coreg) Use for hypertension and mild to moderate heart failure; can be
alpha 1 , beta 1 , beta 2 used with a thiazide diuretic; PO: 6.25 mg bid; may increase to
12.5 mg bid to maximum 50 mg/d; Pregnancy category: C;
PB UK; half life 7–10 h.
Labetalol (Normodyne) Mild to severe hypertension; angina pectoris; PO: 100 mg bid;
alpha 1 , beta 1 , beta 2 dose may be increased to a maximum of 2.4 g/day. IV: 20 mg OR
102 mg/kg; repeat 20–80 mg at 10-min interval to maximum dose
of 300 mg/day. Pregnancy category C; PB 50%; half life 6–8 hours.
Nadolol (Corgard) Management of hypotension and angina pectoris. Contraindicated
beta 1 , beta 2 in bronchial asthma and severe COPD. PO: 40–80 mg/d; maximum
320 mg/day. Pregnancy category: C; PB 30%; half life 10–24 h.
Selective Beta Adrenergics
Metoprolol tartrate Management of hypertension, angina pectoris, postmyocardial
(Lopressor)—beta 1 infarction. Hypertension: PO: 50–100 mg/d in 102 divided doses;
maintenance 100–450 mg/d in divided doses to maximum of
450 mg/d in divided doses. Myocardial infarction: IV: 5 mg q2
min x 3 doses, then PO: 100 mg bid. Pregnancy category C;
PB 12%; half life 3–4 h.
Atenolol (Tenormin)— Mild to moderate hypertension and angina pectoris. May be used
beta 1 in combination with antihypertensive drugs. PO: 25–100 mg/d.
Pregnancy category: C; PB 6–16%; half life 6–7h Esmolol HCl
(Brevibloc)—beta 1. Supraventricular tachycardia, atrial fibrillation/
flutter, and hypertension. Contraindications: heart block,
bradycardia, cardiogenic shock, uncompensated CHF; IV: Loading
dose 500 /kg/min for 1 min; then 50 g/kg/min for 4 min.
Pregnancy category C; PB UK; half life 9 min.