Patient
Education

What are beta blockers?

Beta-adrenergic blocking agents, commonly known as beta blockers, are used in the treatment of high blood pressure (hypertension). Some beta blockers are also used to relieve angina (chest pain), correct irregular heartbeat, prevent migraine headaches, treat tremors or to help prevent additional heart attacks in heart attack patients.

How do they work?

Beta blockers decrease the heart rate and cardiac output, which in turn lowers blood pressure. Essentially, they work by blocking the action of noradrenaline at special sites (receptors) in arteries and the heart muscle. Noradrenaline is a chemical that transmits messages between nerves and muscles, or between one set of nerves and another. By blocking this action, beta blockers can cause arteries to widen and can slow the action of the heart and decrease its force of contraction. This results in a fall in blood pressure and reduced work by the heart so that it beats more regularly.

Are there side effects?

The most common side effects of beta blockers are insomnia, cold hands and feet, tiredness or depression, a slow heartbeat or symptoms of asthma. Impotence may occur.

Are beta blockers for everyone?

People should avoid using beta blockers if they have asthma, chronic bronchitis, emphysema or any other condition that affects breathing, since beta blockers can make these conditions worse by narrowing the air passages in the lungs. People with poor blood circulation, diabetes, stable heart failure, and kidney or liver problems should also use extreme caution when taking beta blockers.

How are beta blockers taken?

Beta blockers are available by prescription only. They can be taken through pills, injections, or eye drops (for glaucoma) and are often prescribed in combination with other drugs such as diuretics or calcium channel blockers.

What types of drugs are considered beta blockers?

• Acebutolol (Sectral®)
• Atenolol (Tenormin®)
• Betaxolol (Kerlone®)
• Bisoprolol/hydrochlorothiazide (Ziac®)
• Bisoprolol (Zebeta®)
• Carteolol (Cartrol®)
• Metoprolol (Lopressor®, Toprol XLTM)
• Nadolol (Corgard®)
• Propranolol (Inderal®)
• Sotalol (Betapace®)
• Timolol (Blocadren®)

Sources:

National Institute of Health

American Heart Association

Healthy Hearts.com

British United Provident Association (BUPA)

WHAT IS COUMADIN?

Coumadin is an anticoagulant.  An anticoagulant helps reduce clots from forming in the blood.

WHEN SHOULD I TAKE MY COUMADIN?

Try to take your Coumadin at the same time every day.  Take it exactly the way your healthcare provider tells you.

WILL MY DOSAGE CHANGE?

Your dosage may change from time to time.  So make sure you take the right dose on the right day, as your healthcare provider tells you.

WHY DO I NEED BLOOD TESTS?

To help your healthcare provider establish the dosage of Coumadin you need.  Your healthcare provider will take a small amount of your blood to find out your prothrombin time, protime, or PT for short.  Protimes are very important.  They help to show how fast your blood is clotting and whether your dosage of Coumadin should change.

WHAT THINGS MAY CHANGE MY PROTIME TEST RESULTS?

Several things, such as sickness, diet, other medicines (prescription and over-the-counter), or physical activities may affect your results.  Tell your healthcare provider about changes in your health, medicines you are taking, or your lifestyle so your dosage of Coumadin can be adjusted if needed.

WHAT SHOULD I AVOID?

• Avoid drastic changes in you dietary habits.
• Avoid alcohol consumption.

WHAT IF I FORGET TO TAKE A COUMADIN PILL?

DO NOT TAKE ANOTHER PILL TO “CATCH UP”!  If you forget to take a pill, tell your healthcare provider.  Take the missed dose as soon as possible on the same day, but DO NOT take a double dose of Coumadin the next day to make up for the missed dose.

WHY DO I NEED TO PAY ATTENTION TO MY DIET?

Because many foods you eat have vitamin K in them, and vitamin K helps your blood make clots.  In addition, you may want to avoid herbal teas that have tonka beans, melilot (sweet clover), or sweet woodruff in them.

WHY SHOULD I STAY ON THE SAME GENERAL DIET EVERY DAY?

Because large changes in the amount of vitamin K you eat may affect the way your Coumadin works.  It is important for you to keep your diet steady (consistant) so the amount of vitamin K you eat is steady.

SHOULD I AVOID FOODS WITH A LOT OF VITAMIN K?

No. Just keep your diet steady. Some foods that are important to a healthy diet are high in vitamin K, like leafy, green vegetables and some beans and peas.

WHAT SHOULD I DO?

• Do take your Coumadin exactly as your healthcare provider tells you.
• Do keep eating habits and activities similar every day.
• Do get your blood tested when you are suppose to.
• Do tell your healthcare provider about any other medicines you are taking (prescription or over-the-counter).  Also, ask your healthcare provider before you change, start, or stop taking any of your medicines.
• Do tell you healthcare provider when you get sick, get hurt, or get a cut that won’t stop bleeding.
• Do look for signs of bleeding.
• Do tell anyone giving you medical or dental care that you are taking Coumadin.
• Do refill you prescriptions according to your healthcare provider’s order.

WHAT SHOULD I NOT DO?

• Do not take and extra pill to catch up.
• Do not take Coumadin if you are pregnant or may become pregnant.
• Do not take any other medicines before asking your healthcare provider.

CALL YOUR HEALTHCARE PROVIDER RIGHT AWAY IF YOU HAVE…

• A serious fall or if you hit your head
• Bleeding that does not stop from cuts or from your nose
• More bleeding then usual when you brush your teeth
• More bleeding then usual when you get your menstrual period or unexpected bleeding from the vagina
• Unusual colored urine or stool when you go to the bathroom (including dark brown urine and red or black in your stool)
• Unusual bruising (black-and-blue marks on your skin) for unknown reasons
• A fever or sickness that gets worse
• Throwing up (vomitting), coughing or throwing up blood, loose or runny stools (diarrhea) or an infection
• Pain or swelling
• Headache, dizziness, trouble breathing, chest pain, or if you feel weak or more tired than usual