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Evolution and mechanism of action of beta-blockers Types of betablockers: Nonselective betablockers Selective betablockers Betareceptor Location: Heart Positive chronotropic effects (increases heart rate) Positive inotropic effects (increases contractility of the myocardium) Kidney Increased release of renin, which in turn increases blood pressure Betareceptor Location: Smooth muscle cells Promotes relaxation Skeletal muscle cells Promotes tremor and increased glycogenolysis Liver Increases glycogenolysis Betareceptor Location: Adipose tissue Induces lipolysis Administration: intravenous and oral Firstgeneration nonselective betablockers Affect all betareceptors

High levels of dietary fat impair glucose homeostasis in rainbow trout

Martnez-Martnez L-A, Mora T, Vargas A, et al

The gradual dose titration schedule as per the UK SmPC (starting at 2.5 mg weekly and increasing incrementally) aims to minimise these effects by allowing physiological adaptation

Normal fasting glucose is below 100 mg/dL