Name of Patient

F. S.

Age

35 y.o

Height

53

Diagnosis

G3P3 (3003) PU del. ceph. term live birth by 1oLSTCS +

BTL w/ variable deaceration; severe preeclampsia
M. M. Olmillo

Sex

Female

Weight

60 kg

Website

milkv.co.vu

A/N

youre welcome J

Author

DRUG DATA
Generic name:
Metoprolol

CLASSIFICATION
Pharmacologic:
Beta1-selective
adrenergic blocker

Trade name/s:
Troprol XL
Patients dose:
50mg BID

Therapeutic:
Antihypertensive

Maximum dose:
450 mg PO
Minimum Dose:
50 mg PO BID
Availability:
Tablets 25, 50,
100mg; ER
tablets 25, 100,
200mg; injection
1mg/ml

Pregnancy category
risk: C

MECHANISM OF
ACTION

Competitively blocks
beta-adrenergic
receptors in the heart
and juxtaglomerular
apparatus, decreasing
the influence of the
sympathetic nervous
system on these
tissues and the
excitability of the
heart, decreasing
cardiac output and the
release of renin, and
lowering BP; acts in
the CNS to reduce
sympathetic outflow
and vasoconstrictor
tone

Onset:15min
Route:
PO

INDICATIONS

General:
> hypertension,
along wit other
drugs, especially
diuretics
> prevention of
reinfarction of MI
patients who are
hemodynamically
stable or within 310 days of the
acute MI
> long-term
management of
angina pectoris
> treatment of
stable,
symptomatic heart
failure of
ischemic,
hypertensive or
cardiomyopathic
origin

Peak: 90 min
Duration: varies
Metabolism: hepatic;
3-4 hr
Distribution: crosses
placenta, enters
breast milk

Patients actual
indication:
Metoprolol is
given to patient
for the treatment
of pregnancyinduced
hypertension

Excretion: urine

CONTRAINDICATI
ON

ADVERSE
EFFECTS

Drug hypersensitivity,
sinus bradycardia,
greater than first-degree
heart block, cardiogenix
shock, or overt cardiac
failure when used to treat
hypertension or angina.
When used to treat MI,
contraindicated in
patients with heart rate of
less than 45 bpm,
greater than first degree
heart block, systolic
blood pressure less than
100 mm Hg, or moderate
to severe cardiac failure.

Allergic:
laryngospasm

Precautions:
Patients with heart
failure, diabetes,
respiratory or hepatic
disease

Dermatologic:
rash, pruritus,
sweating, dry skin

Drug Interactions:
Barbiturates, rifampin:
Increased metabolism of
metroprolol
Cardiac glycosides,
diltiazem, verapamil:
Excessive bradycardia
and increased
depressant effect on
myocardium.
Catecholamine-depleting
drugs such as H2
antaginists, MAO
inhibitors

CNS: dizziness,
vertigo, tinnitus,
fatigue, emotional
depression
Respiratory:
bronchospasm,
dyspnea,
pharyngitis
CV: heart failure,
cardiac
arrhythmias

EENT: eye
irritation, dry eyes,
conjunctivitis

NURSING
RESPONSIBILITIE
S

Before:
> Check doctors order.
> Review medication record.
> Record VS, esp. BP and HR
> Note for dizziness, fatigue,
dyspnea.
> Determine hypersensitivity.
During:
> Introduce self to client.
> Confirm clients identity.
> Read drug label.
> Inform drugs therapeutic effect.
> Inform of side effects
After:
> Evaluate therapeutic response.
> Watch for adverse effects.
> Tell patient to inform prescriber if
shortness of breath occurs.
> Inform patient that use of
metroprolol isnt advised in
breastfeeding women.
> document and record

GI: gastric pain,

flatulence,
constipation,
diarrhea, nausea,
vomiting
GU: impotence,
decreased libido
Musculoskeletal:
joint pain, muscle
cramp
Other: decreased
exercise tolerance

Source: 2011
Lippincotts NDG

Source: 2011
Lippincotts NDG

Source: 2011
Lippincotts NDG

Source: 2011
Lippincotts NDG

Source: 2011
Lippincotts NDG

Source: 2011
Lippincotts NDG

Source: 2011 Lippincotts Nursing

Drug Guide