Metoprolol Flashcards
What is another name for Metoprolol?
Lopressor
What drug class is Metoprolol in?
Beta-blocking agent
How does Metoprolol work?
The Beta1-blocking action on the heart decreases heart rate, conduction velocity, myocardial contractility and cardiac output. Metoprolol is used to control ventricular response in supraventricular tachydysrhythmias (SVT, Afib, Aflutter).
It is considered a second line agent after Adenosine, Diltiazem or a digitalis derivative.
What is the onset of Metoprolol?
1-2 minutes
What is the duration of Metoprolol?
3-4 hours
What are the indications for Metoprolol?
- all patients with suspected MI and unstable angina (it can reduce the incidence of VF)
- useful as an adjunctive agent with fibrinolytic therapy
- convert to NSR or to slow ventricular response in supraventricular tachydysrhythmias
- reduce myocardial ischemia in AMI patients with elevated heart rate, blood pressure or both
What are the contraindications for Metoprolol?
- hemodynamically unstable patients
- STEMI if increased signs of cardiogenic shock are present
- 2nd or 3rd degree heart block, active asthma, reactive airway disease, severe bradycardia, SBP <100mmHg
What are some adverse reactions of Metoprolol?
- bradycardia
- AV conduction delays
- hypotension
- palpitations
- N/V
What are some drug interactions with Metoprolol?
- may potentiate antihypertensive effects when given to patients taking calcium channel blockers or MAO inhibitors
- catecholamine-depleting drugs may potentiate hypotension
- sympathomimetic effects may be antagonized; signs of hypoglycemia may be masked
How is Metoprolol supplied?
1mg/mL ampules
5mg/5mL ampules
What is the adult dosage of Metoprolol?
5mg slow IV push at 5 minute intervals to a total of 15mg (3 doses)
What are some special considerations for Metoprolol?
- pregnancy safety category C
- concurrent IV administration with IV calcium channel blockers (Verapamil, Diltiazem) can cause severe hypotension
- use with caution in persons with liver or renal dysfunction
