Beta-blockers on the NCLEX
Beta-blocker class for NCLEX: -olol ending, action, when to hold, side effects, and the teaching points the NCLEX hammers.
Beta-blockers end in -olol. Action: block beta-1 (heart) and sometimes beta-2 (lungs) receptors. The NCLEX tests when to hold, which patients to avoid them in, and the masking-hypoglycemia teaching point.
Common drugs
Metoprolol (cardioselective beta-1), atenolol (cardioselective), propranolol (non-selective), carvedilol (alpha + beta), labetalol (alpha + beta, pregnancy-safe).
Action and use
Block beta receptors, decreasing heart rate and contractility. Used for HTN, MI post-care, HF (carvedilol, metoprolol succinate), arrhythmias, anxiety/performance (propranolol off-label).
Hold parameters
Hold for HR <60 or SBP <90. Always check apical pulse one full minute before administration.
Side effects
Bradycardia, hypotension, bronchospasm (especially non-selective in asthma/COPD), fatigue, masks hypoglycemia symptoms in diabetics.
Teaching points
Don't stop abruptly, rebound tachycardia and HTN. Change positions slowly. Diabetic patients: check blood sugar regularly (you won't feel shakiness).
Frequently asked
Which beta-blocker is safest in pregnancy?
Labetalol is the standard for HTN in pregnancy.
Can asthmatics take beta-blockers?
Cardioselective (metoprolol, atenolol) often used cautiously. Non-selective (propranolol) generally avoided.
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