Jan 25, 2023
Beta Blocker Generations Mnemonic PRO BAM CARLAB
In this episode, I go over how you can use PRO BAM CARLAB to remember the beta blocker generations and what that means for pharmacology indications and adverse effects.
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Welcome to the Memorizing Pharmacology podcast. I’m Tony Guerra, pharmacist and author of the Memorizing Pharmacology book series, bringing you mnemonics, cases, and advice for succeeding in Pharmacology. Sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com forward slash P forward slash moving. Let’s get started with the show.
In this episode, I’m going to go over beta blocker generations mnemonic Pro bam car lab and I’ll explain what I mean there. So before we start with the stems, let’s just make sure that you’ve heard this that the all at the end of a beta blocker which indicates it’s a beta blocker. There are some exceptions to that but it’s two B’s backward so it’s Propranolol but if you connect the O and the L it should look like two backward B’s and the stems are a little bit different but also cause a problem.
The first generation stem a law is the same as the second generation stem a law o-l-o-l and that causes a problem because Propranolol has beta 1 and beta 2 blocking activity and then second generation has beta one with bisoprolol Atenolol metoprolol so that’s why you kind of need the mnemonic to separate like okay which is first generation the pro and think of primary it’s your first grade and then bam b-a-m for your second generation.
Then I put Car Lab just to give you two of the third generation ones these guys are very clever in their stems and they kind of fixed the all problem if you want to call it that so these third Generations will vasodilate and you see d-i-l-o-l in Corvette de la and you see a for Alpha Blocker in La Bay to law so that little change the dill and the a for Alpha blocking helps you know okay well these are third generation at least I get these guys but I still need to be able to tell the difference between first and second generation.
Okay so when we kind of go to the next thing, the indications and giant schf hypertension really when we’re going to the generations we’re going to almost avoid problems as much as they are indications. So when you look at Propranolol when they first came out I mean this came out so long ago many of the patients were like my migraines are gone it’s like oh well let’s just try to use it for that and Propranolol is really good at helping prevent migraines in the first place.
The issue is though because that beta 2 blocking activity we have these second generation bisoprolol Atenolol metoprolol which avoid the asthmatic issue of beta 2 blockade in general but then we want something that might print vent reflex tachycardia so if you can think of Carvedilol and labetalol as alpha blockers with beta blocking activity so that when you vasodilate which is a problem with the alpha blockers like prazasin you can prevent that reflex tachycardia because you are suppressing beta 1 receptors.
So again, Propranolol is the beta 1 and beta 2 blocker, bisoprolol, Atenolol, metoprolol these are the beta one only, and then Carvedilol labetalol these are the beta one beta 2 and Alpha One blockers.
Adverse effects tend to come from the mechanism of action so bradycardia can be a problem so if you get the heart rate below 60 and really a contraindication when you don’t really want somebody to go that low bronchospasm specifically with that Propranolol where you are battling that beta 2 receptor fatigue is really a big deal because think about it you go on a run and your heart rate increases but you’re taking a medicine that won’t let your heart rate increase so you’re going to get fatigued.
A heart block if you use too much of it and then reflex tachycardia can come from stopping it abruptly so imagine that you’re kind of pushing down on a spring and then all of a sudden you let your hand go well that’s kind of what you’re doing if you take away a beta blocker very quickly.
The considerations kind of come from the adverse effects so you want to be considerate of somebody who has asthma or COPD because if we’re using a beta blocker how do we choose the right one well if they’ve got asthma then we’re not going to choose that first generation somebody’s bradycardia certainly we don’t want to suppress their reduce their blood pressure too low.
This one’s a big one, mask the signs and symptoms of hypoglycemia. So normally someone who’s hypoglycemic is going to get kind of very jittery palpitations but with a beta blocker they may not feel that at all and go into a hypoglycemic State and it might be masked or covered up.
So again, hopefully that quick review of beta blockade and the generations kind of puts it together really quickly and if you need my help Tony the pharmacist gmail.com. This information is provided for informational purposes only this is not medical advice if you have a medical question contact a medical professional.
Thanks for listening to the Memorizing Pharmacology podcast. You can find episodes, cheat sheets, and more at memorizingfarm.com. Again, you can sign up for the email list at memorizingfarm.com to get your free suffixes cheat sheet or find our mobile-friendly self-paced online pharmacology review course at residency.teachable.com forward slash P forward slash Melbourne. Thanks again for listening.
Like to learn more?
Find my book here: https://geni.us/iA22iZ
and subscribe to my YouTube Channel TonyPharmD here: https://www.youtube.com/c/tonypharmd
Here is the Link to my Pharmacy Residency Courses: residency.teachable.com