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Names / Class
Non-Selective Beta Blocker
Mechanism of Action
- Non-selective beta blocker and selective alpha1 blocker.
- Peripheral vasodilation (Blockage of alpha1)
- Decreased HR
- Decreased contractile force
- Decreased automaticity (all due to blockage of beta1 & beta2)
- = Decreased BP by reduction in cardiac output
Onset of Action
- 2 - 5 minutes
- 5 - 15 minutes
- 2 - 4 hours
- 3 - 8 hours
- Hypertensive emergency: markedly elevated BP causing end-organ changes such as altered mental status, CP, renal failure.
- **HA & anxiety associated with HTN are NOT indications
- Bronchial asthma
- Acute CHF
- Heart block
- Cardiogenic shock
- Monitor BP, pulse, & EKG continuously
- Due to effects on beta1, postural hypotension may occur and should be anticipated. Pt should remain supine at all times while administering.
- Atropine should be available.
- Do not administer if Pt is receiving IV calcium channel blockers.
- Administer with caution to Pt taking antihypertensive agents.
2 accepted methods:
1. 20mg slow IV or IO injection over 2 minutes. Supine BP should be taken immediately prior to and 5 - 10 minutes after administration. Additional injections of 40mg can be given every 10 minutes until desired supine BP is achieved or max dose of 300mg is given.
2. 500mg added to 250mL of D5W (1.0 mg/mL) at a rate of 2 mg/min to a max dose of 300mg. BP should be constantly monitored.
Routes / How Supplied
Slow IV or IO injection; infusion