| B1 Selective Blockers | Non-Selective Blockers (B1 and B2) | Mixed Blockers (Beta and alpha) | |
| Hydrophilic | acebutolol, atenolol, bisoprolol (both), esmolol | nadolol, pindolol, sotalol | |
| Lipophilic | bisoprolol (both), metoprolol, nebivolol | propranolol | carvedilol, labetalol |
Some points:
- Avoid mixed and non-selective agents in asthma. Alpha blockade causes vasodilation, decreases peripheral resistance, and causes no reflex tachycardia. (acronym: Can Let No Purple People Start)
- Lipophilic agents reduce remodeling and protect against sudden death.
- Patients sometimes feel worse when starting carvedilol. Start low and titrate up.
- Estrogen increases blood pressure
- Labetalol is preferred anti-hypertensive in pregnancy, followed by nifedipine and methyldopa.