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DocWils Offline

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Post: #11
RE: beta blockers
This is a standard pre testing dose. Don't worry about it - your heart can't bottom out so easily, there are a lot of mechanisms built in to prevent that, and even rolling over is enough to raise your heart rate. You may not feel as energetic and you may (or may not) feel like s**t when you get up, but otherwise, the only thing you should do is keep an eye out for an of the major side effects mentioned on the enclosed literature, and look out for allergic effects, again written about on the enclosed literature. I doubt that your cardiologist took the sept of giving you an Rx for that without knowing what he was doing, and since he knows your case well, I would go along. Your greatest fear anyway would be interactions with your other meds - so long as that is cleared by your pharmacist, you will be fine.

They don't actually work by slowing your heart beat per se, they work by blocking the receptor to epinephrine. In addition, they lower the renin secretions in the kidneys, which lowers the heart oxygen volume demand by increasing the oxygen carrying capacity of the blood. This means the heart doesn't need to work so hard to move the O2 around, and so doesn't beat as hard (or as fast) and doesn't respond as drastically to adrenaline surges (this is of course a vast oversimplification, "lies to children" in the current science parlance, but sufficient for laymen, or doctors for that matter (we're not all chemists and microbiologist, you know)). We give these meds even to patients with congestive heart failures, and it reduces morbidity effectively, so if your cardiologist thinks it is warranted, he is most likely right.
12-08-2013 05:17 AM
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me50 Offline

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Post: #12
RE: beta blockers
I am not worried because I just have to take it the night before and the morning of the test and since my heart rate is 72 and within normal limits and not at the upper end of normal, I feel confident that all will be okay. I hope that I don't feel sh***y enough that it makes it hard to drive to the test lol When I finish the test, I will come home, drink a lot of water and probably sleep as I heard the beta blockers make you sleepy according to the pharmacist and the cardiologist (who is a 2nd opinion doctor).
12-08-2013 07:48 AM
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DocWils Offline

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Post: #13
RE: beta blockers
If you are only taking two day's worth of doses, it shouldn't make you feel anything - it takes a while for these to have any real effect, and here it is used purely as a preventative measure. Nothing to worry about. And you shouldn't feel too sleepy, if you do, just yawn and shake your head, and it will go away.
12-08-2013 02:14 PM
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justMongo Offline

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Post: #14
Beta Blockers new thread
I'm on Metoprolol Succinate (extended release.)
Metoprolol is not the best beta blocker from the lipophilic (ability to cross the blood brain barrier) standpoint; and may disturb sleep.

For me, a fairly low dose 50mg/day causes my heart rate to fall into the 30s during sleep at nadir.

I take it partially for BP control -- although it's not my heavy hitter. I also have some arrhythmia although bothersome, not life threatening.

It's been around long enough to go off-patent.
What are the newer beta blockers? Especially those that are less lipophilic beta blockers.

I have to withdraw from it next week for a Lexiscan stress test and nuclear (Tc99) imaging study. I'd like some options when I restart beta blockers. Less lipophilic beta blockers would be preferred.

Yes, I understand info on this board is not medical advice -- I'd just like some options to present to my cardio doc.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
12-13-2013 07:50 PM
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DocWils Offline

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Post: #15
RE: Beta Blockers new thread
Sorry to say, your cardio doc is your best resource for any next gen information. The type of beta blocker you take is indicated for certain conditions and responses, and that can only be addressed by your doctor.
12-14-2013 06:59 AM
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me50 Offline

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Post: #16
RE: Beta Blockers new thread
(12-13-2013 07:50 PM)justMongo Wrote:  I'm on Metoprolol Succinate (extended release.)
Metoprolol is not the best beta blocker from the lipophilic (ability to cross the blood brain barrier) standpoint; and may disturb sleep.

For me, a fairly low dose 50mg/day causes my heart rate to fall into the 30s during sleep at nadir.

I take it partially for BP control -- although it's not my heavy hitter. I also have some arrhythmia although bothersome, not life threatening.

It's been around long enough to go off-patent.
What are the newer beta blockers? Especially those that are less lipophilic beta blockers.

I have to withdraw from it next week for a Lexiscan stress test and nuclear (Tc99) imaging study. I'd like some options when I restart beta blockers. Less lipophilic beta blockers would be preferred.

Yes, I understand info on this board is not medical advice -- I'd just like some options to present to my cardio doc.

just curious. did your cardiologist tell you if 30 is too low to drop when sleeping?
12-14-2013 07:26 AM
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justMongo Offline

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Post: #17
RE: Beta Blockers new thread
(12-14-2013 07:26 AM)me50 Wrote:  just curious. did your cardiologist tell you if 30 is too low to drop when sleeping?
He didn't bat an eye. My GP found it interesting -- but not concerned.

Looks like the latest Beta Blocker is Bystolic. In addition to selective beta blockade, it also has some vasodilation effect that reduces cardiac load.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
12-14-2013 08:47 AM
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DocWils Offline

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Post: #18
RE: Beta Blockers new thread
That's up to your cardiologist to decide - if he thinks it is better for you, he'll switch you over, if not, he has his reasons, but of course you are free to ask him what they are. Make no mistake, he knows every drug on the market that has to do with the heart or circulatory system. And I can think of at least a dozen reasons to not put a patient on Bystolic, none of which you need to be concerned about. The right drug for the right fit, that is the key here, and that can only be established by the guys in the white coats who know you and your case best.
12-14-2013 10:10 AM
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SuperSleeper Offline

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Post: #19
RE: beta blockers
Mongo, I merged your new thread on beta blockers with this one, since it's the same subject matter.

Thanks. Coffee

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12-14-2013 10:28 AM
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justMongo Offline

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Post: #20
RE: Beta Blockers new thread
(12-14-2013 10:10 AM)DocWils Wrote:  That's up to your cardiologist to decide - if he thinks it is better for you, he'll switch you over, if not, he has his reasons, but of course you are free to ask him what they are. Make no mistake, he knows every drug on the market that has to do with the heart or circulatory system. And I can think of at least a dozen reasons to not put a patient on Bystolic, none of which you need to be concerned about. The right drug for the right fit, that is the key here, and that can only be established by the guys in the white coats who know you and your case best.

Agreed. But sometimes one must be ones own advocate in this era of managed care. I had a very special doctor-patient relationship with my former GP who retired in 2012. He would give me the package insert -- tell me to take it home and read it; then we would discuss the pros and cons of taking it. Medicine is by mutual consent between the doctor and patient. The role the patient takes is in accord with the patients knowledge and comprehension of medicine. Some patients are more sophisticated than others.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
12-14-2013 03:45 PM
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