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Mechanism of Action Selective 1 blockade mainly affects heart and kidneys heart rate (negative chronotropy) myocardial contractility (negative inotropy) renin release from the kidneys angiotensin II BP Minimal effect on 2 receptors (lungs, vasculature) safer in mild asthma than non-selective beta-blockers Pharmacokinetics Absorption: Oral, 4050% bioavailability Distribution: Limited CNS penetration (less sedation) Metabolism: Minimal (mostly excreted unchanged by kidneys) Half-life: ~67 hours Excretion: Renal Clinical Uses Hypertension: Alone or in combination Angina pectoris: myocardial oxygen demand Acute myocardial infarction: Secondary prevention Arrhythmias: Atrial fibrillation, supraventricular tachycardia Migraine prophylaxis: Off-label use Hyperthyroidism / thyrotoxicosis: Controls tachycardia Adverse Effects Cardiovascular: Bradycardia, hypotension, heart block, worsening heart failure CNS: Fatigue, dizziness Metabolic: Mild triglycerides, HDL