Metoprolol (Lopressor)

Question 1

Metoprolol Class?

Answer 1

Beta Blocker

Question 2

Metoprolol Action?

Answer 2

Blocks beta-adrenergic receptor sites in the heart, lungs and blood vessels. The beta 1 blocking action on the heart decreases heart rate, conduction velocity, myocardial contractility, and cardiac output. The beta 2 effects may cause bronchoconstriction.

Question 3

Metoprolol Indications?

Answer 3

Supraventricular tachycardia (SVT/PSVT), Atrial Fibrillation, Atrial Flutter, to reduce myocardial ischemia and damage in acute myocardial infarction/unstable angina

Question 4

Metoprolol Contraindications?

Answer 4

Hypersensitivity, hemodynamically unstable pts, CHF, decreased cardiac output, cardiogenic shock, 2nd or 3rd degree heart blocks, bradycardia, SBP < 100.

Question 5

Metoprolol Onset/Duration?

Answer 5

Onset: 1-2 min
Duration: 6-8 hours

Question 6

Metoprolol Dose/Route?

Answer 6

Adult: 5 mg slow IV at 5 min intervals and may repeat up to 15 mg max.

Peds: Not recommended in prehospital setting

Question 7

Metoprolol Side Effects?

Answer 7

Bradycardia, hypotension, AV conduction delays, palpitations

Question 8

Metoprolol Note*

Answer 8

If given concurrently with calcium channel blockers, such as verapamil and cardizem, may cause severe hypotension. Caution in pt’s with liver/renal dysfunction and asthma.