Beta-Blockers

Key points

• Indications: angina · post-MI · heart failure (improve symptoms AND mortality) · arrhythmias (now replace digoxin as rate-control of choice in AF) · hypertension (diminished role — no stroke/MI reduction evidence) · thyrotoxicosis · migraine prophylaxis · anxiety.
• Propranolol is lipid-soluble → crosses blood-brain barrier.
• Side-effects: bronchospasm · cold peripheries · fatigue · sleep disturbance/nightmares.
• Contraindications: uncontrolled heart failure · asthma · sick sinus syndrome · concurrent verapamil (severe bradycardia).

Decision points in this pathway

• Any contraindication present?

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.