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27 Cards in this Set

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A brand of metoprolol is?
Lopressor
The pharmacologic action of metoprolol is?
beta blocker
Therapeutic classification of metoprolol is?
antianginal
antihypertensive
The indications for metoprolol use is?
hypertension
angina pectoris
prevention of MI
management of stable symptoms
(class II or III) heart
failure due to ischemic,
hypertensive, or
cardiomyopathic origin
Unlabeled uses for metoprolol are?
ventricular arrhythmias/
tachycardia
(Davis doesn't have
metoprolol listed as
antidysrhythmic agent)
migraine prophylaxis
tremors
aggressive behavior
drug-induced akathisia
anxiety
Which beta adrenergic receptors does metoprolol block?
beta 1 (myocardial)
Which beta adrenergic receptors does metoprolol NOT block?
beta 2 (pulmonary, vascular,
uterine)
What are the therapeutic effects of metoprolol?
decreased blood pressure and
heart rate
decreased frequency of
attacks of angina pectoris
decreased rate of CV
mortality and hospitaliza-
tion with heart failure
What should nurse monitor for a patient on metoprolol?
blood pressure
ECG
pulse
Monitor VS and ECG how often?

if heart rate is less than 40 bpm, especially if cardiac
output is also decreased
every 5-15 minutes during and for several hours after parenteral administration...administer atropine 0.25-0.5 mg IV when?
What else should be monitored concerning CHF?
I & O
daily weights
symptoms of CHF:
dyspnea
rales/crackles
weight gain
peripheral edema
jugular venous distention
What kind of attack should be assessed for during therapy?
anginal
What lab results may INCREASE when taking metoprolol?
BUN
serum lipoprotein
potassium
triglyceride
uric acid levels
ANA titers
blood glucose levels
serum alkaline phophatase,
LDH, AST, and ALT levels
Take which pulse before administering metoprolol?

50 bpm or if arrhythmia occurs...what should nurse do if this happens?
apical...withhold medication if pulse is less than?

notify physician
When is a good time to administer metoprolol?
with meals or directly after eating
Instruct patient to take med as directed, at the same time each day, even if feeling well...if dose missed, what then?

up to 8 hrs before next dose
don't skip if possible, don't double up...how long does patient have to take a missed dose?
Abrupt withdrawal of metoprolol may precipitate?
life-threatening arrhythmias, hypertension, or MI
Don't drive. Metoprolol may cause?
drowsiness
Change positions slowly to minimize?
hypotension
Metoprolol may cause increased sensitivity to?
cold
Consult physician before taking OTC meds, esp?
cold preparations...avoid caffeinated products as well
What should a diabetic monitor for closely and what symptoms might occur while taking metoprolol?
monitor blood glucose
look for:
weakness
malaise
irritability
fatigue

(med does not block sweating
as a sign of hypoglycemia)
Advise patient to notify hcp if?
slow pulse
difficulty breathing
wheezing
cold hands and feet
dizziness
light-headedness
confusion
depression
rash
fever
sore throat
unusual bleeding
bruising
Concerning hypertension...reinforce need to continue additional therapies for hypertension which are?
weight loss
sodium restriction
stress reduction
regular exercise
moderation of alcohol
consumption
smoking cessation
Effectiveness of therapy can be demonstrated by?
decrease in blood pressure
reduction in frequency
of anginal attacks
increase in activity
tolerance
prevention of MI
<Case study #8: angina pectoris...medications prescribed on discharge two days following hospitalization for angina pectoris?>
<metoprolol (Lopressor)
100 mg qd

atorvastatin (Lipitor) 20 mg
qd

NTG 0.4 mg SL 1 q 5 min X 3
prn chest pain>
<Case study #8: angina pectoris
What should nurse teach patient about metoprolol (Lopressor)?>
<decreases blood pressure and
heart rate
monitor before administration>