Medicine & USMLE


Alpha and Beta Blockers (Old)
  1. Phenoxybenzamine
  2. Phentolamine
  3. Alpha-1 Antagonists (Prazosin, Terazosin, Tamsulosin)
  4. Beta-1 Selective Blockers (Atenolol, Esmolol, Metoprolol)
  5. Combined Alpha-Beta Blockers (Carvedilol, Labetalol)
  6. Non-selective Beta-Blockers (Propranolol, Timolol)
  7. Nebivolol


Nebivolol is a beta-blocker drug that is clinically used to treat hypertension. It does this by way of two different mechanisms. The first is to block beta-1 receptors leading to decreased cardiac output. The second is to stimulate beta-3 receptors causing an increase in nitric oxide production, causing vasodilation that reduces systemic vascular resistance. It is the decreased cardiac output and decreased vascular resistance that together lead to the lowering of blood pressure.

Key Points

  • Nebivolol
    • Mechanism of Action
      • Blocks Beta-1 receptors
        • decreases Cardiac Output
      • Stimulates Beta-3 receptors
        • increases Nitric Oxide (NO) production
    • Clinical Use
      • Hypertension (UTD)
        • Beta 1 blockade → Decreased Cardiac Output → Decreased BP
        • Beta 3 stimulation → NO Production → Vasodilation → Decreased BP
    • Adverse Effects
      • AV Block
        • Beta-1 blockade causes decreased dromotropy, and will present with elongated PR Interval