Mechanisms of action and the clinical pharmacology of beta-adrenergic blocking drugs.

At present more than 20 beta-adrenergic blocking drugs are commercially available in Western Europe, and six are available in the United States. The clinical indications for their usage include hypertension, arrhythmias, ischemic heart disease, thyrotoxicosis, migraine headaches, glaucoma, and anxiety states. We will review the mechanisms suggested for the antihypertensive action of beta-adrenergic blocking drugs as well as these agents' clinical pharmacologic aspects. In general, the pharmacodynamic effects of the beta blocking drugs are quite similar, yet the properties of biotransformation, including pharmacokinetics, tend to be distinguishing features.