Beta Blockers

Mar 9, 2021

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

"Why are they stealing catalytic converters?" Doris pointed to a news report that said nearly $400,000 worth of damage had recently been done to cars in Winnipeg. Almost 80 cars had their catalytic converters ripped out in January 2021 alone. I tried to use this crime spree as a teachable moment. Eric keeps telling me that there is no point in taking chemistry in school. I told him that chemistry is important even in a life of crime. Platinum is the catalyst in catalytic converters. The platinum helps change like the harmful nitrogen oxides in tailpipe emissions into harmless nitrogen gas and oxygen gas. Because it is a catalyst, the platinum is not used up in the chemical reaction. Platinum prices are high right now and that is what makes catalytic converters valuable. The high prices of many metals have led many scrap yards to look into additional security. Emily saw a scrap yard in Saskatoon where security involved Transformers and a T-Rex.

Thankfully, we don't need Transformers or a T-Rex to provide security in the pharmacy. The most dangerous thing I see is when a customer pulls out a bottle of pills, shakes them in my face and demands "What are these for?" If the pills are nitrofurantoin, the answer is easy. Nitrofurantoin is an antibiotic that is only used for bladder infections. If the pills are beta-blockers, it is a much harder question to answer. Beta-blockers have many, many different uses. We'll start with how important adrenaline is in your body. Let's say we pull a Jurassic Park and put you next to a T-Rex. What do you do? Fight or flee? And yes, there is only one right answer.

This is what adrenaline what made for. That fight or flight reaction when presented with a T-Rex. Adrenaline starts pumping and your heart beats faster, your blood pressure goes up, your lungs open up and blood goes to your muscles instead of your stomach. These are the perfect reactions for your body to have when fighting or running from the T-Rex. However, in our modern world, apart from Saskatoon scrap yards, there aren't too many T-Rex's to run from. But, after you discover your car has had its catalytic converter stolen, you are pumped full of adrenaline anyway. You have a ton of adrenaline released even though there is no one in front of you to fight and no one to run from. Adrenaline release because of the stresses from modern life can be maladaptive. In fact, an overactive adrenaline system can actually harm the body over time.

We have medications that can block the effects of adrenaline in the body. Adrenaline is made in the adrenal glands which sit on top of the kidneys. Beta-blockers stop adrenaline from reaching its receptors all over the body. As a pharmacist, the thing I find the most fascinating about beta-blockers is that blocking these adrenaline receptors can be used to treat so many different conditions.

High blood pressure. Beta-blockers have been a popular and effective blood pressure pill for years. They do slow down the heart, but they probably decrease blood pressure by affecting the renin system.

Irregular heartbeat. Because beta-blockers stop the adrenaline from reaching their receptors on the heart, they slow down the heart rate. This slowing of the heart rate also decreases irregular heartbeats.

Heart failure. When the heart is failing, the body produces a lot of adrenaline to deal with this stressful event. However, the stimulation of the heart muscle by the adrenaline further weakens the heart muscle. When adrenaline is blocked, it leads to less stress on the heart muscle. The beta-blockade also may decrease the inflammatory mediators that the damaged heart releases and might affect cardiac remodeling.

Heart attack. After a heart attack, the heart muscle is damaged. Beta-blockers act like a governor on a golf cart engine. They don't let the heart beat too fast. This means the heart muscle needs less oxygen. This allows the heart muscle to recover better.

Migraine. Beta-blockers aren't helpful if you have a migraine right now, but they might prevent you from having your next one. They are a standard treatment for preventing migraines, but we aren't really certain how they work. We think they might affect adrenaline in the brain, but they also might affect other brain chemicals like serotonin.

Cheating at the Olympics and playing Carnegie Hall. Beta-blockers are banned in shooting sports. Because beta-blockade stops the effects of adrenaline, they stop the shaking of your hands if you are nervous during your Olympic archery or pistol competition. This is considered an unfair advantage, so they are banned. They don't drug test classical musicians, so some take beta-blockers to help with stage fright before big performances.

PTSD- Post Traumatic Stress Disorder. This is what soldiers can get after seeing horrible things in war or paramedics can get after seeing horrible things on the job. Here we are going into the more nebulous or experimental uses of beta-blockers. There are standard treatments for PTSD and they often involve antidepressants. Some researchers think beta-blockers might help to prevent PTSD. The idea is if you give beta-blockers to a soldier right after the horrible event, this will block the effect of adrenaline in the body. One of the effects of adrenaline is to make memories stick. Researchers think that blocking adrenaline might prevent normal memories from becoming PTSD memories.

Emily found a scrap yard in Saskatoon that had some really cool metal sculptures standing guard around it. She sent us pictures of very colorful Transformers that really were made from car hoods and doors. There was an enormous globe in all its rusty glory. My favorite was obviously the twenty-foot-tall T-Rex. This metal king of the lizards looked like he might really come after you if you tried to steal from the scrap yard. If he did, that would definitely be an appropriate time for your body to produce adrenalin.

As always if you have any questions or concerns about these or other products, ask your pharmacist.

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.


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