Atenolol is not lipid soluble therefore it has longer half life than Metaprolol which is lipid soluble. Carvedilol blocks both alpha and beta receptors and is the most common beta blocker used in chronic congestive heart failure because it has Antioxidant and Antimitogenic properties in addition. Esmolol has the shortest and Nadolol has the longest half life among all beta blockers. Beta Blockers must not be used in compensated (i.e) acute heart failure. Beta blockers that are excreted in kidneys (lipid insoluble): Nadalol, Satolol, Atenolol, Acebutalol, Bisprolol, Betaxolol, Celioprolol- Should be avoided in renal failure. Endogenous Norepinephrine is metabolized by COMT and MAO. Exogenous Norepinephrin is metabolized by reuptake. Hemicholimium- Blocks the reuptake of Choline Vesamicol- prevents entry of choline into storage vesicles. Glucagon is DOC in beta blockers overdose. Other drugs that are used- Norepinephrine and Calcium chloride. Cardioselective Beta Blocker used in Glaucom
Science progresses by questioning the existing dogmas.