Metoprolol
Drug | Metoprolol |
Brand names | Dutoprol ®, Kapspargo ®, Lopressor ®, Lopressor Hct ®, Toprol ®, Seloken ® |
Indications | Mycoardial ischemia. Perioperative hypertension. |
Mechanism of action | Beta-1 adrenergic blocker. |
Effects | Lowers blood pressure, reduces heart rate, myocardial oxygen consumption and myocardial contractility. Less pronounced blood pressure lowering effect than esmolol and labetalol. |
Time to onset of action | 20 minutes |
Duration of action | 5 to 8 hours |
Delivery | IV |
Dose | 1.25 to 5 mg IV followed by 2.5–15 mg IV every 3 to 6 hours. |
Adverse effects | Vomiting. Dizziness. Nausea. Atrioventricular blocks (AV-blocks). Orthostatic hypotension. Paresthesias (scalp tingling). Bronchospasm. |
Caution | • Avoided in hypertensive emergencies with acute heart failure. • Used cautiously in patients with asthma (due to risk of bronchospasm). • Used cautiously in bradycardia due to negative chronotropic effect. |