Before taking an alpha blocker, be sure your doctor knows about other medications you take, such as beta blockers, calcium channel blockers or medications for erectile dysfunction. Alpha blockers can increase or decrease the effects of other medications you take. Alpha blockers may improve total cholesterol The new postsynaptic alpha-receptor blocker prazosin, is generally free of the side effects that precluded the use of alpha-blockers which affected both pre- and postsynaptic receptors. Is is moderately effective and, excepting the problem of first-dose hypotension, it is usually well tolerated
Fatigue and skin rashes are side effects of alpha-beta blockers. The critical mechanism of action of alpha-beta blockers lies in the combination of two distinct drug classes Sexual Side-Effects. A lot of men who take Flomax and other alpha-blockers for benign prostatic hyperplasia bph tend to experience side-effects that affect their sexual health. Several types of sexual side-effects may occur in men. When looking at the effects of alpha-blockers, it seems like these drugs may improve erectile function. There are. Doctors may also prescribe combined alpha- and beta-blockers for people who are at high risk of heart failure. People may experience the side effects of both alpha- and beta-blockers ACE inhibitors or angiotensin receptor blockers are often effective when combined with other classes of medications. Sometimes, a beta-blocker is combined with an alpha-blocker. This may be useful for men who have hypertension and an enlarged prostate. The alpha-blocker may help both problems at the same time Side effects vary among different beta blockers because some are more selective than others. This means that some only act on beta receptors in the heart (cardioselective) whereas others also affect beta receptors located elsewhere, such as in the lungs (nonselective). Some beta-blockers, such as atenolol, are only cardioselective at low dosages
Side Effects and Treatment When a patient begins Alpha blockers or Beta blockers, it is not unusual for him to feel tired and dizzy. In time these side effects subside. Another side effect of taking a Beta blocker is weight gain Unlike beta blockers, alpha-blocker drugs aren't typically used as the first treatment for hypertension. Instead, they're often combined with other drugs, such as diuretics, to manage high blood pressure. Alpha-blockers work by preventing a hormone called norepinephrine from binding to your alpha-adrenergic receptors There are other important side effects and serious adverse effects of this drug class that include, blurred vision, insomnia, hair loss, disorientation, CNS system effects, and serious heart problems Beta blockers, also known as beta-adrenergic blocking agents, are medications that reduce your blood pressure. Beta blockers work by blocking the effects of the hormone epinephrine, also known as adrenaline. Beta blockers cause your heart to beat more slowly and with less force, which lowers blood pressure
Combined alpha and beta-blockers are used as an IV drip for those patients experiencing a hypertensive crisis. They may be prescribed for outpatient high blood pressure use if the patient is at risk for heart failure. A noted possible side effect of combined alpha and beta-blockers: May cause a drop in blood pressure when you stand u Possible side effects of alpha-beta blockers that you may not notice: Some people may have problems with the electrical system of their heart. Not everyone who takes an alpha-beta adrenergic blocker will have these side effects. You should not be afraid to take your medicine because of the side effects listed
Adrenergic antagonists have inhibitory or opposing effects on the receptors in the adrenergic system. The adrenergic system modulates the fight-or-flight response.Since this response, which is mostly seen as an increase in blood pressure, is produced by the release of the endogenous adrenergic ligands, administration of an adrenergic antagonist results a decrease in blood pressure, which is. Beta-blockers. Beta-blockers cause the heart to slow down and so some of their side effects can be traced to that mechanism of action. Dizziness, weakness, fatigue, and fainting are possible. Beta-blockers also affect the respiratory system, so other side effects include shortness of breath, difficulty breathing, and chest pain A bunch of beta blockers. You can tell a beta blocker by its generic name — they all end in lol. Each has its own particular way of blocking beta receptors. This accounts for their different actions and side effects. More than a dozen beta blockers have been approved for use in the United States (see table). They fall into three main groups Side effects of Combigan include the symptoms of beta blockers and alpha agonists. Side effects of Cosopt include burning and/or stinging of the eyes and changes in sense of taste. Side effects of Simbrinza Suspension include blurred vision, eye irritation, bad taste, dry mouth, and eye allergy
Combination antihypertensives include combined agents from the following pharmacologic classes: diuretics and potassium-sparing diuretics, beta blockers and diuretics, angiotensin-converting. . The most common side-effects are slight drowsiness, headaches and dizziness. More rarely they can cause sexual problems. Alpha-blockers are also associated with an increased risk of falling and of breaking a bone (fracture) when they are. Some beta blockers affect all types of beta-adrenergic receptors while others are specific for one of three beta receptors: β1—heart and kidneys, β2—lungs, liver, uterus, gastrointestinal tract, vascular smooth muscle, and skeletal muscle, and β3—fat cells. Below are 10 side effects of beta blockers to be aware of Drs. Horn and Hansten are both professors of pharmacy at the University of Washington School of Pharmacy. For an electronic version of this article, including references if any, visit www.hanstenandhorn.com.. Depending on the situation, combining epinephrine and beta-blockers can be completely innocuous in one person and life-threatening in another Warning. Oral route (Tablet) Following abrupt cessation of certain beta-blocking agents, exacerbations of angina pectoris and, in some cases, myocardial infarction and ventricular arrhythmias have occurred. As with other beta blockers, when discontinuation of atenolol is planned, the patients should be carefully observed and advised to minimize physical activity
The National Institute for Health and Clinical Excellence in the United Kingdom, an advisory group that develops national health policy, has placed a limited caution against the combined use of beta-blockers and thiazide diuretics for people at high risk for diabetes (because of family history, impaired glucose tolerance, or obesity, for example) Alpha vs Beta Blockers Alpha and beta blockers are drugs or medications that are used for the treatment of hypertension, blood pressure, and other related symptoms. Both these types of drugs work to allow smooth flow of blood in veins inside our bodies, thus helping to lower the blood pressure Variable: Side effects can be specific to the individual. Newer beta blockers, like bystolic, (nebivolol) have potentially fewer side effects for most, but not indicated by fda for WPW (can be used off label). In general second generation water solube and cardioselective beta blockers like atenolol or metoprolol have fewer side effects than 1st generation lipid soluble beta blockers (like. Beta-blockers work by blocking the effects of epinephrine.This causes your heart to beat more slowly and pump with less force. The result is that your heart doesn't have to work as hard and is. In addition to these side effects, a significant research study known as the ALLHAT Study found that long-term use of alpha-blockers seems to increase the risk of heart failure. While this risk is real, it is small, and the main reason that alpha blockers are not used as a first-choice drug is because, unlike other high blood pressure medicines.
There are some very specific negative side effects possible when taking beta blockers. WEBWIRE - Sunday, July 15, 2012 It's unpopular to criticize popular medications because it strikes an. Beta blockers are commonly prescribed to those with hyperthyroidism and Graves' disease. While antithyroid medication (i.e. Methimazole, PTU) helps to lower thyroid hormone levels, beta blockers mainly help with the cardiovascular symptoms associated with hyperthyroidism, although some beta blockers can inhibit the conversion of T4 to T3. In this article I'll discuss how beta blockers work. Asthma medications act to potentiate the effects of beta blockers, increasing the risk for toxicity. Beta blocker medications can cause bronchospasm, which can trigger an asthma attack. Nonselective beta blockers have effects on beta1 and beta2 receptors and can cause bronchospasm, so are contraindicated in patients who have asthma
Cardiovascular side effects. Many of the side effects of beta-blockers are related to their cardiac mechanisms and include bradycardia, reduced exercise capacity, heart failure, hypotension, and atrioventicular (AV) nodal conduction block. All of these side effects result from excessive blockade of normal sympathetic influences on the heart Cardiovascular medications. Beta blockers have CNS effects—some of which cause psychiatric syndromes—that might depend on an ancillary property such as lipophilicity. 2 Unlike hydrophilic agents such as atenolol that are excreted unchanged by the kidneys, lipophilic drugs such as metoprolol and propranolol are metabolized by the liver and are believed to enter the brain Some beta blockers also bind to alpha receptors to some degree. This allows them to induce a different clinical outcome when used in certain settings. Once beta blockers bind to the B1 and B2 receptors, they inhibit these effects. Therefore, the chronotropic and inotropic effects on the heart are inhibited and the heart rate slows down what you should do if you experience side effects; and what you should do if you miss a dose. There are several different medications available for the treatment of glaucoma including 1) beta-blockers, 2) prostaglandin analogues, 3) Alpha agonists, 4) carbonic anhydrase inhibitors, and 5) combined agents Difference Between Alpha and Beta Blockers Alpha vs Beta Blockers One of the deadliest diseases in the world today is hypertension. To prevent such illnesses, the human body needs to have these blocking agents to aid their veins in the smooth flow of blood circulation. Alpha and Beta Blockers are often supporting medications that will assist in the lowering of blood [
Silvestri et al.. Report of erectile dysfunction after therapy with beta-blockers is related to patient knowledge of side effects and is reversed by placebo. European Heart Journal. 2003 : p.1928-1932. doi: 10.1016/j.ehj.2003.08.016 . | Open in Read by QxM Eye medications work by decreasing the production of the aqueous fluid in the eye (Beta Blockers, Carbonic Anhydrase Inhibitors, Alpha-agonists), facilitating aqueous fluid drainage out of the eye (Cholinergic-Miotic and Prostaglandin Analogs) or combination of both functions Most beta blockers produce these CNS & sexual side effects to some extent. With regards to how beta-blockers cause insomnia, it has been observed that beta-1 blockers decrease the release of melatonin, a compound involved in sleep & circadian rhythm. To put this in context, ramelteon (Rozerum ®) is a melatonin agonist used to treat insomnia Side Effects. Side effects occur more frequently in older animals and those that are unstable due to cardiac disease. The most common side effects include bradycardia, conduction disturbances, hypotension, depression, loss of appetite, and diarrhea. Precautions. Beta blockers such as atenolol should not be used in animals that are hypotensive.
. The alpha-adrenergic branch remains fully active. This means that you get vasoconstriction (from alpha adrenergic stimulation) but with a reduced cardiac output (from the beta blockers slowing the heart rate) The side effects include itchy skin, dry eyes, weight gain, a slow heart rate, weakness, high blood sugar, diarrhea, low blood pressure, tiredness, dizziness, nausea, and headache. Some of these effects may be visible when the dose begins but may go away as your body is accustomed to the medication One of the most common side effects with alpha blockers is the first dose effect. This is a phenomenon in which patients with hypertension take an alpha blocker for the first time, and suddenly experience an intense decrease in blood pressure. Ultimately, this gives rise to orthostatic hypotension, dizziness, and a sudden loss of consciousness. Contraindications for beta blockers may include asthma. A slower than normal heartbeat, known as bradycardia, can also be dangerous when combined with beta blockers. Since the main action of these drugs is to reduce heart rate, the presence of bradycardia can lead to an extremely low heart rate that is unsustainable Coreg belongs to a class of drugs called Beta-Blockers, Alpha Activity. It is not known if Coreg is safe and effective in children. What are the possible side effects of Coreg? Coreg may cause serious side effects including: lightheadedness, slow or uneven heartbeats, cold feeling or numbness in your fingers or toes, chest pain, dry cough.
The side effects of combining beta blockers and cocaine are often silent. Vasospasms (blood vessel constriction) may cause chest pain, but it is common to have no noticeable symptoms. Vasospasms may result in tissue damage, heart problems, stroke or death Beta blockers are a class of medications commonly used to treat cases of high blood pressure. Use of either aspirin or beta blockers can harm your health in combination with fish oil. Use of aspirin with beta-blockers can also potentially cause problems. Seek your doctor's advice before taking any of these medications Side Effect #2: Weight Gain. Weight gain occurs when there is increase in body weight due to increase in fluids, muscle mass, fat deposits, or other factors. Weight gain is a known side effect of some beta blockers, especially the older beta blockers such as metoprolol and atenolol General Beta-blockers: efficacy in cardiovascular diseases Drugs blocking beta adrenergic receptors (beta-blockers) have become central to the management of cardiovascular diseases. Specifically, they have proven efficacy in: 1. Treatment of angina 2. Prevention of recurrent myocardial infarction 3. Treatment of hypertension 4. Treatment of symptoms of heart failure due to systolic dysfunction. Summary Propranolol and timolol are nonselective beta blockers with both beta 1 and beta 2 blocking activity. Blocking of beta-1 receptors reduces cardiac output by slowing down the heart rate and reducing contractility, while beta-2 blockade has minor positive effects and mainly leads to a host of side effects. These drugs are used for a variety of cardiovascular conditions, including.
Beta-blockers may cause intra-uterine growth restriction, neonatal hypoglycaemia, and bradycardia; the risk is greater in severe hypertension. Breast feeding With systemic use in the mother, infants should be monitored as there is a risk of possible toxicity due to beta-blockade Propranolol is the best studied beta-blocker for migraine, 4 and it is FDA-approved for migraine prevention. 5 Timolol is also FDA-approved for migraine prevention. 6 Migraine prevention is an off-label (unapproved)—but common—use of metoprolol. 7 In people with episodic migraine, propranolol and metoprolol prevent about 1 headache per month. 8 Studies of propranolol suggest it may.
Heart. Beta-blockers bind to beta-adrenoceptors located in cardiac nodal tissue, the conducting system, and contracting myocytes.The heart has both β 1 and β 2 adrenoceptors, although the predominant receptor type in number and function is β 1.These receptors primarily bind norepinephrine that is released from sympathetic adrenergic nerves USED AS A COMBINATION OF - NOT A FIRST LINE TREATMENT. In elderly metabolism may be impaired which elevate level of Metoprolol this cause side effects. Give an example of a drug that is a third generation Beta blocker? What are the Adverse effects caused by Third generation Beta blockers blocking Alpha 1 receptors? Hypotension Dizziness For access to a full NCLEX Review Course, click here: https://www.mometrix.com/university/courses/nclex*Subscribe for more great NCLEX videos: https://www.go..
What are the cutaneous adverse effects of beta-blockers? Psoriasis. Beta-blockers are a well-recognised trigger to exacerbate or precipitate psoriasis.. Typical de novo drug-induced psoriasis may manifest as pustular psoriasis in the absence of joint or nail changes.; Studies suggest that exacerbations of psoriasis due to beta-blockers are more likely to occur in patients 50 years of age or older Side effects. Like all other drugs, beta blockers can induce some side effects including: bradycardia - heart rhythm can fall below 40 beats per minute. hypotension - the blood pressure can be lowered significantly, causing symptoms. bronchoconstriction - narrowing of bronchi can induce an asthma attack . Like prostaglandin analogs, alpha-adrenergic agonists reduce intraocular pressure by promoting drainage of fluid within your eyes. These kinds of drugs include Apraclonidine/Iopodine and Brimonidine/Alphagan P. Common side effects of alpha-adrenergic agonists include: Burning or stinging sensation of the eyes; Fatigue.
Combination Medicines diabetes or overactive thyroid should talk to their doctor about the specific risks of using any of these Beta-Blockers. Common Side Effects Peripherally Acting Alpha. In choosing among the beta-blockers, combined alpha/beta-blockade offers advantages over beta-blocker monotherapy and merits greater clinical and research attention. Finally, unreliable bioavailability greatly interferes with the effectiveness of lipophilic, but not nonlipophilic, beta-blockers
Beta-blockers are drugs that can help slow heart rate, prevent migraine episodes, manage glaucoma, and more. Learn more about the uses of beta-blockers here Due to their additional vasodilating effects Beta-blockers of the 3rd generation are particularly useful in patients with arterial hypertension and/or heart failure. However, beta-blockers have been questioned in the treatment of arterial hypertension since they may cause metabolic side effects, whereas this obviously does not hold true for the. Timolol's ability to lower pressure is used as the gold standard for how good other drops need to be. There are different strengths (0.25%, 0.5%, and 1%) of some of the beta blockers available. The possible side effects of beta blockers are both eye problems and general body issues What are some cardiac side effects of beta blockers? 1. Decreased phase 4 depolarization 2. Poor LV ejection due to peripheral vasoconstriction 3. Increased effects with exercise Name the combined alpha & beta blockers? 1. Labetolol 2. Carvedilol . Which receptors does labetolol work on?. Beta blockers can have side effects like most medicines, but in this case, they tend to be more annoying than dangerous. What is a beta agonist? Beta agonists are a type of medicine used to treat asthma (and sometimes other lung conditions). 4 They are sometimes known as bronchodilators because they relax the airways
Side effects of beta-blockers. Most people taking beta-blockers have either no or very mild side effects that become less troublesome with time. Contact your GP if you're experiencing symptoms that affect your everyday life. They can discuss whether the symptoms are a result of the medication and what to do Alpha blockers have several other side effects that are also worrisome. Terazosin has been linked to: fatigue, lack of energy and loss of strength. In addition to dizziness this drug could cause sleepiness, nasal congestion and erectile dysfunction (ED) So in layman's terms, beta blockers only block the beta receptors. They then, as with amphetamines, transfer the load to the alpha receptors, leaving you more susceptible to heart attack. The ideal medicine to take with stimulants would be a combined alpha/beta blocker. Hope this helps Different types of beta blockers can block receptors in various organs. Many beta blockers bind to the B1 and B2 receptors, so they inhibit their effects. Some experts describe beta blockers as relieving stress on the heart because they give the heart a break from working and pumping so hard Side effects (clonidine vs placebo): fatigue 17% vs 8%; sleepiness 30% vs 6%; dry mouth 37% vs 6% (all statistically significant) Findings: Among men, race and age have an important effect on the response to single-drug therapy for hypertension
The most common side effects of beta blockers are: Fatigue. Because beta blockers cause your heart rate to decrease, it's common to feel a slight reduction in energy. Some people who use beta blockers feel fatigued after starting treatment due to the effects of the medication on the heart Objective: Melatonin is a mediator in the establishment of the circadian rhythm of biological processes. It is produced in the pineal gland mainly during the night by stimulation of adrenergic beta1- and alpha1-receptors. Sleep disturbances are common side-effects of beta-blockers. The influence of specific beta-blockade as well as that of combined alpha-and beta-blockade on melatonin.
For more information on the side effects of beta blockers, read about the specific medicine you take in our Medicines A to Z. Missed or extra doses Most beta blockers are taken once a day, apart from certain beta blockers that are used during pregnancy and Sotalol, which is given 2 or 3 times a day Third generation beta-blockers offer fewer side effects Fourthly, also according to the recent ESC/ESH Guidelines for the management of arterial hypertension, (3) beta-blockers should be used in patients with arterial hypertension and added angina pectoris, post-myocardial infarction, heart failure, tachyarrhythmias, glaucoma and/or pregnancy Lastly, let's review unique side effects of beta blockers which include hypoglycemia, bronchospasm, round bound tachycardia and hypotension. If you patient has COPD or is a brittle diabetic, this drug class will be a tough one to manage If the alpha-blocker has been prescribed to treat BPH, talk with your doctor about the possibility of switching to a 5-alpha-reductase inhibitor such as dutasteride (Avodart) or finasteride (Proscar), which are safer and generally better tolerated by older patients. Meds That May Cause Insomnia. 1. Alpha-blockers 2. Beta-blockers 3.
The elderly population tends to experience more pronounced side effects and consequences from drug (P = .04) and combined CVD (P <.001). 17 Therefore, alpha-blockers should not be used as first-line agents in complicated hypertension in the elderly and should only be of which alpha-blockers, beta-blockers, CCBs, diuretics, ACE. Beta blockers that work on both beta-1 and beta-2 are referred to as nonselective. They could be expected to have any of the effects listed in the table above. This could be a problem for someone with a lung issue such as asthma if the beta blocker made the airways tighten. Non Cardio Selective Beta Blockers A number of studies have evaluated the use of beta-blockers in patients with COPD. 1,3-7 As was observed in studies in patients with asthma, COPD patients being treated with beta-agonists showed no detrimental effects (reduced airway function or disease exacerbations) of cardioselective beta-blockers. 1,4 A retrospective study of COPD patients. Potential Side Effects of Beta Blockers. Beta-blockers have many benefits for people who have cardiovascular problems. They may not suffer as much anymore. Lowering the heart rate and blood pressure alone is already reason enough to love beta-blockers. But like almost everything else, we will need to deal with drug's side effects Beta-blockers are used to treat high blood pressure (hypertension), congestive heart failure (CHF), abnormal heart rhythms (arrhythmias), and chest pain (angina).Beta-blockers are sometimes used in heart attack patients to prevent future heart attacks.. How do beta-blockers work? Beta-blockers block the effects of adrenaline on your body's beta receptors
Alcohol, combined with a calcium channel blocker, can cause severe side effects and may also affect the way the medication works. Side effects from taking calcium channel blockers are usually. Beta-blockers. Beta-blockers in the management of acute coronary syndrome (ACS) Early use of beta-blockers (i.e., within 24 hours) in the absence of contraindications (below) is recommended in the management of ACS as it decreases morbidity and mortality, reduces infarction size, and prevents ventricular fibrillation Antidiabetics — beta-blockers may mask warning signs of hypoglycaemia, such as tremor. Calcium channel blockers. The combination of a beta-blocker and verapamil should not be prescribed because bradycardia, asystole, severe hypotension, and heart failure can occur
However, beta-blockers are widely used to treat hypertension and heart disease, and it is necessary to screen elderly patients on these agents from time to time for possible cerebral side effects. If there is any suspicion of cognitive impairment, then one should withdraw the beta-blocker Additional drugs－calcium channel blockers and combined alpha and beta blockers－were given during some of the trials. Authors' conclusions: Currently, no evidence suggests that beta blockers adversely affect walking distance, calf blood flow, calf vascular resistance and skin temperature in people with intermittent claudication For this reason alone, some ophthalmic pharmaceutical companies have produced combination eye drops that can include different anti-glaucoma medicines in the same bottle. Side Effects of Beta Blockers. Most medicines have side effects so just to be clear, ask your pharmacist about the side effects of each medicine you consume Alpha 1 blockers have also been found effective in the prevention and treatment of post-traumatic stress disorder, particularly in reducing trauma-related nightmares. However, alpha 1 blockers may also have pronounced side effects and, as shown in the ALLHAT trials, doxazosin may increase the risk of heart failure over long-term use
Beta-blockers, also written as β-blocker, also called beta- adrenergic receptor blocking agents, it binds to beta receptors present on the cells of the heart, arteries, kidneys and other tissues stimulated by the stress hormones such as adrenaline and noradrenaline Beta blockers work by blocking the effects of the hormone adrenaline, also known as epinephrine. They cause the heart to beat more slowly and with less force, which lowers blood pressure Fans of (Coreg) this combined [alpha]- and [beta]-blocker say it's distinguished from other [beta]-blockers by its lack of adverse metabolic effects. It doesn't worsen insulin resistance, peripheral arterial disease, or lipid profiles
The anti-anxiety effects of beta-blockers can be reduced by heavy caffeine intake, as caffeine has the potential to increase anxiety overall. Specifically, caffeine may interact with the beta-blockers propranolol and metoprolol, causing an increase in blood pressure. Propranolol and metoprolol are commonly prescribed to treat heart disease and. . Others: Terazosin and Doxazosin. Similar drugs such as terazosin and doxazosin are also developed to help maintain the blood pressure of hypertensive patients Side effects of beta blockers include bronchospasm, bradycardia, increased heart block, hypotension, reduced exercise tolerance and CNS depression. Patients with diabetes may experience reduced glucose tolerance and masking of hypoglycemic signs and symptoms. Abrupt withdrawal of ocular beta blockers can exacerbate symptoms of hyperthyroidism An estimated 70% of men who have side effects from high blood pressure medicine stop taking it. like hydrochlorothiazide) and beta-blockers a combination of medications might work better.
Beta Blockers List. Beta blockers are a class of medicines that are administered in the treatment of several medical conditions. I present to you a comprehensive article on the types of beta blockers, their mechanism of action, indications, contraindications and side effects Dosage does make a difference in alcohol's combination with beta-blockers. Beta-blockers like propranolol metabolize quickly. Therefore, the longer you wait between taking beta-blockers and drinking alcohol, the lower the chances of overlap. A low dosage of beta-blockers (like the 10mg dosage generally prescribed for performance anxiety), will
Inderal (propranolol) is in a group of drugs called beta-blockers. Although primarily used for heart conditions, Inderal has off-label use as an anxiolytic Beta blockers can have the effect opposite of what was intended when combined with cocaine. Cocaine use makes beta blockers less effective due to opposing effects on the cardiovascular system, and beta blockers may paradoxically worsen the cardiac effects during cocaine intoxication. Side Effects of Mixing Cocaine and Beta Blockers Less common side effects include sleep problems and impotence (men). Be aware that beta blockers can interfere with other medications which may cause unpleasant side effects. Check with your GP if you are taking an over the counter or prescribed medicine before taking beta blockers Lopressor may increase the hypertensive effects of alpha-adrenergic blockers. Concomitant administration with beta-blockers may enhance the vasoconstrictive action of ergot alkaloids. In general, administration of beta-blockers should be withheld before dipyridamole testing, with careful monitoring of heart rate following the dipyridamole.