DRUG

NAME
BRAND
NAME:
Betaloc

GENERIC
NAME:
Metoprolol

DRUG
ACTION

CONTRAINDICA
TION

Treatment of
hypertension
as sole agent/
in combination
withother
antihypertensi
ves (esp.
thiazide
diuretics)
To
decreas
e
mortalit
y rate in
MI
Long
term
treatme
nt of
angina.
ACTION:
blocks access
of
catecholamine
nuerotransmitt
ed to beta
receptors
located in
heart;
antihypertensi
ve effect not
determined.

Hypersensitivity,
cardiogenic shock,
heart block, overt
cardiac failure,
sinus bradycardia.
CC: abrupt D/C
can exacerbate
ischemic heart
disease.
Use can
result in
possible
cardiac
failure with
decrease
myocardial
contractility
Use with
caution in
presence of
bronchospas
tic disease,
diabetic,
peripheral
vascular
disease.
Tachycardia
of
hyperthyroi
dism can be
masked,
abrupt D/C
may induce

DOSAGE

Adult

Angina PO
100-400mg/d
Hypertension
PO 100450mg/d
MI early IV/PO
3 bolus
injection of
5mg at 2m
interval
followed in
15m by 50mg
PO q6h for
48h.
Thereafter
100mg bid
MI late PO
100mg bid

Lopressor HCT
50/25 2
tablets/d
100/25 1-2
tablets/d
100/50 1
tablet/d

SIDE/ADVER
SE EFFECTS

INTERACTI
ONS

CNS: tiredness,
dizzness,
depression,
mental
confusion
CV:
bradycar
dia,
palpitatio
ns,
shortness
of breath,
cold
extremite
s, CHF
GI: N/D,
gastric
pain
constipat
ion,
flatulenc
e
INT:
prupitus,
rash
Other:
wheezing
,
peyronie'
s
disease.

Use with
reserpine,
other
catecholami
ne depleting
drug can
result in
serious
adrenergic
blockage.

NURSING MANAGEMENT

Instruct patient to take medication

as directed, at the same time each
day, even if feeling well; do not
skip or double up on missed
doses. Take missed doses as soon
as possible up to 8 hr before next
dose. Abrupt
withdrawal
may
precipitate
life-threatening
arrhythmias,
hypertension,
or
myocardial ischemia.
Teach patient and family how to
check pulse daily and BP biweekly
and to report significant changes
to health care professional.
May cause drowsiness. Caution
patient to avoid driving or other
activities that require alertness
until response to the drug is
known.
Advise patient to change positions
slowly to minimize orthostatic
hypotension.
Caution
patient
that
this
medication
may
increase
sensitivity to cold.
Instruct patient to notify health
care professional of all Rx or OTC
medications, vitamins, or herbal
products being taken and to
consult health care professional
before taking any Rx, OTC, or
herbal products, especially cold
preparations, concurrently with

thyrotoxicos
is
Use may
mask
symptoms
of
hypoglycem
ia
Safety and
efficacy in
children not
established.

this
medication.
Patients
on
antihypertensive therapy should
also avoid excessive amounts of
coffee, tea, and cola.
Diabetics should closely monitor
blood
glucose,
especially
if
weakness, malaise, irritability, or
fatigue occurs. Medication does
not block sweating as a sign of
hypoglycemia.
Advise patient to notify health
care professional if slow pulse,
difficulty breathing, wheezing, cold
hands and feet, dizziness, lightheadedness,
confusion,
depression, rash, fever, sore
throat,
unusual
bleeding,
or
bruising occurs.
Instruct patient to inform health
care professional of medication
regimen before treatment or
surgery.
Advise
patient
to
carry
identification describing disease
process and medication regimen
at all times.
Hypertension: Reinforce the need
to continue additional therapies
for hypertension (weight loss,
sodium
restriction,
stress
reduction,
regular
exercise,
moderation
of
alcohol
consumption,
and
smoking
cessation). Medication controls but
does not cure hypertension.