Bisoprolol, sold under the brand name Zebeta among others, is a beta blocker medication used for heart diseases. This includes high blood pressure, chest pain from not enough blood flow to the heart, and heart failure. It is taken by mouth.Common side effects include headache, feeling tired, diarrhea, and swelling in the legs. More severe side effects include worsening asthma, blocking the ability to recognize low blood sugar, and worsening heart failure. There are concerns that use during pregnancy may be harmful to the baby. Bisoprolol is in the beta blocker family of medications and is of the β1 selective type.Bisoprolol is on the World Health Organizations List of Essential Medicines. Bisoprolol is available as a generic medication. In 2019, it was the 249th most commonly prescribed medication in the United States, with more than 1 million prescriptions. Medical uses
Bisoprolol is currently used for prevention of cardiovascular events following a heart attack in patients with risk factors for disease progression, in the management of congestive heart failure with reduced ejection fraction, and as a second-line agent for hypertension.Bisoprolol may be beneficial in the treatment of high blood pressure, but it is not recommended as a first-line anti-hypertensive agent without an accompanying comorbid condition, for example, congestive heart failure.In cardiac ischemia, the drug is used to reduce the activity of the heart muscle, so reduced oxygen and nutrient demand, and reduced blood supply can still transport sufficient amounts of oxygen and nutrients. Side effects
An overdose of bisoprolol can lead to fatigue, hypotension, hypoglycemia, bronchospasms, and bradycardia.
After contraction, the ventricles must repolarize, or reset themselves, in order to allow for a second depolarization and contraction. The repolarization creates the T wave in the ECG tracing. Diagnosis
An electrocardiogram, or ECG, is used to differentiate between the different types of AV block. In AV block, there is a disruption between the signal traveling from the atria to the ventricles. This results in abnormalities in the PR interval, as well as the relationship between P waves and QRS complexes on the ECG tracing. If the patient is symptomatic from their suspected AV block, it is important that an ECG is also obtained while having symptoms. Physicians may also order a continuous ECG (i.e. Holter monitor or implanted cardiac monitor) to monitor the patient for symptoms and conduction abnormalities over a longer period of time, as AV blocks can be intermittent.Because some types of AV block can be associated with underlying structural heart disease, patients may also undergo echocardiogram to look at the heart and assess the function.Laboratory diagnosis for AV blocks include electrolyte, drug level and cardiac enzyme level tests. Based upon clinical suspicion, the physician may do lab tests to assess for reversible causes of AV block, such as hypothyroidism, rheumatologic disorders, and infections (such as Lyme disease).