Prototype Drug Unit 6- Metroprolol

Question 1

Therapeutic classification

Answer 1

Antihypertensive

Question 2

Pharmacologic classification

Answer 2

Selective beta1-adrenergic antagonist

Question 3

Therapeutic effects and uses

Answer 3

Used for hypertension as a monotherapy or with other antihypertensives.

Question 4

Mechanism of action

Answer 4

Competes with endogenous catecholamines at adrenergic receptors in cardiac muscle. (Decreases heart rate, cardiac output, and blood pressure.)

Question 5

Adverse effects

Answer 5

Fatigue, insomnia, diarrhea, constipation, drowsiness, impotence or decreased libido, hypotension, bradycardia, confusion

Question 6

Black box warning

Answer 6

Do not stop taking abruptly if patient has angina or heart disease. It should be reduced gradually over 1-2 weeks.

Question 7

Contraindications

Answer 7

Don’t give to patients with preexisting cardiac disease such as heart failure, cardiogenic shock, severe bradycardia, and heart block greater than first degree.

Question 8

Drug interactions

Answer 8

Beta blockers create and additive effect, calcium channel blockers suppress myocardial contractility and can lead to bradycardia and additive hypotension. Oral contraceptives and cimetidine can lead to hypotensive effects. Sympathomimetics will cancel out with metoprolol.

Question 9

Treatment of overdose

Answer 9

Plasma volume expanders or vasopressors raise blood pressure. Atropine to counteract the bradycardia. Isoproterenol for bronchospasm (same as propranolol)