ATC Group: C07AB Beta blocking agents, selective

Acebutolol is a beta adrenoceptor antagonist which is cardioselective, i.e. acts preferentially on beta-1 adrenergic receptors in the heart. Its principal effects are to reduce heart rate especially on exercise and to lower blood pressure in hypertensive subjects.

Atenolol is a beta-blocker which is beta₁-selective, (i.e. acts preferentially on beta₁-adrenergic receptors in the heart). Atenolol is without intrinsic sympathomimetic and membrane-stabilising activities and as with other beta-blockers, has negative inotropic effects.

Betaxolol is a cardioselective Beta₁ receptor blocker which, when applied topically to the eye, lowers intraocular pressure. It is thought to produce this effect by reducing the rate of production of aqueous humour.

Bisoprolol is a potent highly beta₁-selective-adrenoceptor blocking agent, lacking intrinsic stimulating and without relevant membrane stabilising activity.

Celiprolol is a vasoactive beta-l selective adrenoceptor antagonist with partial beta-2 agonist activity indicated in mild to moderate hypertension. The beta-2 agonist activity is thought to account for its mild vasodilating properties. It lowers blood pressure in hypertensive patients at rest and on exercise.

Esmolol is a beta-selective (cardioselective) receptor blocking agent. At therapeutic doses esmolol has no significant intrinsic sympathicomimetic activity (ISA) or membrane stabilising activity.

Landiolol is a highly selective beta-1-adrenoreceptor antagonist that inhibits the positive chronotropic effects of the catecholamines adrenaline and noradrenaline on the heart, where beta-1-receptors are predominantly located. Landiolol, as other beta-blockers, is thought to reduce the sympathetic drive, resulting in reduction in heart rate, decrease in spontaneous firing of ectopic pacemakers, slowing the conduction and increase the refractory period of the AV node.

Metoprolol is a cardioselective beta-adrenergic blocking agent. It has a relatively greater blocking effect on beta₁-receptors (ie those mediating adrenergic stimulation of heart rate and contractility and release of free fatty acids from fat stores) than on beta₂-receptors, which are chiefly involved in broncho and vasodilation.

Nebivolol is a racemate of two enantiomers, SRRR-nebivolol (or d-nebivolol) and RSSS-nebivolol (or l-nebivolol). It is a competitive and selective beta-receptor antagonist and it has mild vasodilating properties due to an interaction with the L-arginine/nitric oxide pathway.