No Beta Blocker for Heart Transplant?

[678 Responding]

During a shift change the other day, one of our Medics stated that Beta Blockers should NOT be used to relieve symptomatic Tachycardia in a heart transplant patient, but rather a calcium channel blocker. I was unable to get a reason WHY because I had to run out on a call. I've been trying to research the reason but can not seem to find an answer. If you guys could help me out, that would be great. Thanks!!

Stay Safe.

[owley medic]

I think it is because Calcium channel blockers work directly in the heart on the cardiac muscle it self where as Bata blockers work on the sympathetic nervous system via the vagus nerve which is disconnected in transplant patients. Has the same effect as atropine for brady cardia we do not give it for transplant patients with brady cardia. This is a bit of a guess on my part but i will look further into it.

Ian

[AZCEP]

The best I could find seems to indicate the patient that receives a heart transplant have more sympathetic discharge, so the beta blocker MIGHT create excess vasoconstriction without allowing for the heart rate to remain normally elevated.

I'd have to ask where this other medic heard this. Beta blockers, with any degree of cardiac specificity, would be relatively safe to use.

[fiznat]

...where as Bata blockers work on the sympathetic nervous system via the vagus nerve...

You're a little mixed up. Beta blockers are adrenergic antagonists, meaning yes they reduce sympathetic tone-- but not via the vagus nerve. The vagus nerve transmits parasympathetic activity, not sympathetic. You're right that the vagus is often disconnected during heart transplants, and your point IS a valid one when considering the use of anti-cholinergic drugs like Atropine, but its not the same case with beta blockers.

678, the medic you overheard might have made the same mistake. Like AZCEP said, Beta blockers should work just fine for these patients, unless we're missing something?

[678 Responding]

He might have been mistaken himself, but the next time I see him which should be next friday, I will definitely ask him about it and see what his explanation is.

I myself am also confused over why he said this, as I can't seem to find a rational reason behind it. I also don't see a reason why not to use Beta Blockers. But I will keep everyone informed.

[itku2er]

678 as we discussed in chat I am real interested in this too.

I have been searching since we talked but I cant find the rationale for it either.

so if you find out anything please let me know.

thanks

terri

[owley medic]

finzat:

I stand corrected, I did in fact have it mixed up, I was speaking off the top of my (Empty) head. LOL But you are right. After i posted that I looked into it further , today at work, and inlightened myself. I did have it mixed up. I knew the atropine issue and mistakenly thought that it MIGHT be as i mentioned. Thank you for clearing that up for me. (us)

[vivibonita]

Either one can be used depending on the patient's condition.

[fiznat]

I stand corrected, I did in fact have it mixed up, I was speaking off the top of my (Empty) head. LOL But you are right. After i posted that I looked into it further , today at work, and inlightened myself. I did have it mixed up. I knew the atropine issue and mistakenly thought that it MIGHT be as i mentioned. Thank you for clearing that up for me. (us)

Ah no big deal man. Its one of those detail things that you probably remember only while youre still in school. I've had my nose in the books for the past 11 months on this stuff so safe to say its pretty fresh in my mind haha. I'm sure theres plenty I could learn from your experience, as well.

[itku2er]

Ah no big deal man. Its one of those detail things that you probably remember only while youre still in school. I've had my nose in the books for the past 11 months on this stuff so safe to say its pretty fresh in my mind haha. I'm sure theres plenty I could learn from your experience, as well.

I am learning from this one guys thanks.......OWLEY i am sorry dude.......i got you into this ......