ACTIVE LEARNING TEMPLATE: Medication Metoprolol/Lopressor MEDICATION __________________________________________________________________________ REVIEW MODULE CHAPTER ___________ Beta 1 adrenergic blocker/ antihypertensive, antianginal CATEGORY CLASS ______________________________________________________________________ PURPOSE OF MEDICATION Expected Pharmacological Action Binds selectively to the beta 1 adrenergic receptor. It works by binding to the site and blocking adrenaline from binding to the site. This then causes the heart to beat slower and with less force thereby lowering blood pressure. Therapeutic Use Given as long term treatment of angina pectoris and hypertension management. Prevent reat atrial flutter and reduce cardio vascular mortality after MI. Complications Deminished sexual function, anxiety, diarrhea, insomnia, difficulty breathing, cold hands and feet. Overdose produces bradycardia, hypotension, bronchospasm. May cause peripheral ischemia in those with existing peripheral vascular disease. Contraindications/Precautions Hypersensitivity to metoprolol. Second or third degree heart block. Abrupt withdrawal can produce acute tachycardia, hypertension, ischemia. Drug should be gradually tapered over 1 to 2 wks. Interactions Medication Administration Do not give if BP systole less than 100mmHg. Antidote: Glucagon. Immediate release if starting at 50 mg should be increased slowly, every week or longer intervals. Extended release given 1x daily. Monitor patient BP Nursing Interventions Measure BP prior to admin and near end of dosing inerval to determine if BP is controlled. Monitor for hypotension, shortness of breath, peripheral edema, distended neck veins. Alpha2 agonists like clonidine may increase AV-blocking effect. Herbals: garlic, ginger, ginkgo, licorice. Labs: may increase serum BUN, ANA, phosphate, biliruben, creatine, potassium, ALT, AST. Client Education Evaluation of Medication Effectiveness Theraputic rsponse after start noted 1-2 weeks after. During that time, monitor daily weights to check for wieght gain and increased urinary output. Effectiveness with proper routine dosing of medication should lower BP within normal limits. Do not abruptly discontinue medicaiton. Change from supine to sitting position slowly. Report fatigue and dizziness to provider. Do not use nasal decongestants or OTC cold medicaitons. Do not double doses if one is missed.

Metoprolol Drug Card - Nursing Drug Handbook

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