The Pharmacology of Beta blockers and Ivabradine

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The β-adrenoceptor antagonists also known as beta blockers are an important group of drugs. They were first discovered in 1958, 10 years after Ahlquist had postulated the existence of β-adrenoceptors. We are using beta blockers for various diseases such as hypertension, heart failure atrial fibrillation myocardial infarction. The diseases are really common that most people might have the disease during the life time. To understand how the beta blockers work it is crucial to know and understand what autonomic nervous system is and adrenoceptors. Ivabradine is a new drug which specifically inhibits the I f current in the sinoatrial node to lower heart rate, without affecting other aspects of cardiac function. FDA (US Food and Drug Administration) approved Ivabradines on 2015. Ivabradines are used for heart failure in patients who are contraindicated for beta blockers or taking maximally tolerated doses of beta blockers. Both ivabradine and beta blockers can be used for heart failure and their mechanism of action are different. Although β-blockers have been proven to reduce mortality in chronic HF patients and are recommended as part of a first‐choice treatment of HF, it is important that besides a negative chronotropic effect, the lowered cAMP levels also have a negative inotropic effect. Furthermore, a number of patients do not respond to treatment with β-blockers, and some even experience a worsening of their HF symptoms when given these drugs.

Beta blockers