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MetoPROLOL

Classification

Beta-1 selective beta blocker

Antianginal agent

Antihypertensive

Indications

CCP: Symptomatic atrial fibrillation or atrial flutter with rapid ventricular response

Contraindications

Hypersensitivity to metoPROLOL or its constituents
Second or third-degree AV block
Sick sinus syndrome or sinus bradycardia
Cardiogenic shock
Relatively contraindicated in patients with a history of bronchospastic diseases: generally beta blockers should not be used in individuals with a history of bronchospasm; however due to metoPROLOL's beta-1 selectivity, it may be used with caution and close monitoring

Adult dosages

CCP: Symptomatic atrial fibrillation or atrial flutter with rapid ventricular response

5 mg IV slow push
May repeat every 5 minutes to a maximum of 15 mg, a heart rate < 110/min, or a blood pressure < 100 mmHg

Mechanism Of Action

MetoPROLOL has a preferential inhibitory effect on beta-1 adrenoreceptors, located primarily in the cardiac muscle. At higher doses, metoPROLOL can exert some inhibition on beta-2 receptors in bronchial and vascular tissues.

Pharmacokinetics

Intravenous:

Onset: immediate, depending on clinical setting; 20 minutes when infused over 10 minutes
Peak: 21.5-2 hours (PO immediate-release)
Duration: dose-dependent. 3-6 hours (PO), 5-8 hours (IV)

Adverse Effects

Secondary effects of decreased cardiac output, which can include headache, weakness, dizziness, and lightheadedness
Respiratory symptoms, including shortness of breath, wheezing and bronchospasm, rhinitis, and exertional dyspnea can also occur

Overdose

Provide supportive care. Review J07: Beta Blockers Toxicity for specific guidance.

Warning And Precautions

MetoPROLOL should be used with caution in compensated heart failure; patients must be closely monitored for worsening of their condition.