MED-Metoprolol

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Author:
amerelman
ID:
27564
Filename:
MED-Metoprolol
Updated:
2010-07-21 15:04:45
Tags:
MED Metoprolol
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Description:
MED-Metoprolol
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  1. Functional Class
    Class II Antidysrhythmic (Beta Blocker)
  2. Mechanism of Action
    • Inhibits Beta-1 adrenergic receptors in cardiac muscle
    • Little or no effect on Beta-2 in doses under 100 mg
    • Reduces HR, cardiac output and BP at rest
  3. Indications
    • CP associated with AMI, ACS
    • Angina pectoris
    • SVT
  4. Contraindications
    • Hypersensitivity
    • Sinus bradycardia
    • HB greater than 1 degree (except in patients with artificial pacemaker)
    • Cardiogenic shock (BP<100 systolic)
    • Uncompensated cardiac failure
    • Pregnancy (2nd, 3rd trimesters)
    • Asthma
    • COPD
  5. Precautions
    • Impaired hepatic or renal function
    • CHF controlled by digitalis or diuretics
    • Do not mix with IV calcium channel blockers
  6. Side Effects
    • Bronchospasm
    • Bradycardia
    • Palpitations
    • Edema
    • CHF
    • Reduced peripheral circulations
    • Drowsiness
    • Insomnia
  7. Interactions
    • Drugs whcih slow AV conduction such as digoxin as the effects may be cumulative
    • Glucagon: Metoprolol may blunt the hyperglycemic effects
    • Verapamil or diltiazem may have synergistic effects
  8. Dosage and Route
    • 5 mg slow IVP (over 2-5 mins) q 5 mins max total 15 mg
    • Acute MI: Maintain systolic BP> 100 and HR > 6o
    • SVT: Maintain heart rate 90-100/minute

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