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1. Generic Name: Metoprolol

2. Brand Name:  Lopressor, Nu-Metop , Toprol-XL

3. Stock Dosage:
Adult: IV BOL (early treatment) 5 mg q2min × 3, 50mg PO

4. Classification:  Antihypertensive, antianginal

5. Mechanism of Action:
It lowers blood pressure by β-blocking effects; reduces elevated renin plasma levels; blocks β2- adrenergic receptors in bronchial, vascular smooth muscle

6. Indication/s:

Mild to moderate hypertension

Acute MI to reduce cardiovascular mortality

NYHA class II, III heart failure

Cardiomyopathy

7. Contraindications:

Hypersensitivity to β-blockers

Cardiogenic shock

Heart block (2nd, 3rd degree)

Sinus bradycardia

Sick sinus syndrome

8. Side Effects and Adverse Effects:
CNS: Insomnia, dizziness, mental changes, headaches, confusion, fatigue
CV: Hypotension, bradycardia, HF, palpitations, dysrhythmias, cardiac arrest, AV block, pulmonary/peripheral edema, chest pain
GI: Nausea, vomiting, colitis, cramps, diarrhea, constipation, dry mouth
HEMA: thrombocytopenia, purpura
INTEG: Rash, purpura
RESP: Bronchospasm, dyspnea, wheezing

9. Nursing Responsibilities:
• Monitor B/P during initial treatment. note rate, rhythm, quality; apical/radial pulse before administration; notify prescriber of any significant changes or pulse <50 bpm.

Teach patient

To take immediately after meals; to take medication at bedtime to prevent effect of orthostatic hypotension.

Not to use OTC products containing α-adrenergic stimulants  unless directed by prescriber

To avoid alcohol, smoking, and limit sodium intake

To report bradycardia, dizziness, confusion, fever, sore throat to prescriber

To comply with weight control, dietary adjustments, modified exercise program

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1. Generic Name: Atenolol

2. Brand Name: Tenormin, Tenolin

3. Stock Dosage:
100 mg

4. Classification:  Antihypertensive , antianginal

5. Mechanism of Action:  It blocks stimulation of β-adrenergic receptor within vascular smooth muscle then produces negative chronotropic activity, slows conduction of AV node, decreases heart rate, negative inotropic activity decreases O2 consumption in myocardium

6. Indication/s:
• Prophylaxis of angina pectoris

•Suspected or known MI (IV use)
•MI prophylaxis, atrial fibrillation/flutter

7. Contraindications:
• Pregnancy
•Hypersensitivity to β-blockers
•Cardiogenic shock
•2nd- or 3rd-degree heart block
•Sinus bradycardia
•Cardiac failure

8. Side Effects and Adverse Effects:;
CNS: Insomnia, fatigue, dizziness, lethargy, drowsiness
CV: Profound hypotension, bradycardia, HF, cold extremities, 2nd- or 3rd-degree heart block
GI: Nausea, diarrhea, vomiting
HEMA: thrombocytopenia purpura
INTEG: Rash, fever
RESP: Bronchospasm, dyspnea, wheezing, pulmonary edema

9. Nursing Responsibilities:
•Assess the patient's apical pulse and blood pressure to confirm they are within normal range.

If pregnancy is planned or suspected:
•do not use in pregnancy and breastfeeding

Teach patient :
• Not to discontinue abruptly
•Take at same time each day as directed
• Not to use OTC products unless directed by prescriber
• To report bradycardia, dizziness, fever
• To take pulse at home; advise when to notify prescriber (heart rate <60 bpm)
• To limit alcohol, smoking, sodium intake
• To comply with weight control, dietary adjustments, modified exercise program

# data[].attributes.body
Mosby's 2019 nursing drug reference (32nd ed.). (2019) Retrieved from https://cdn.fbsbx.com/v/t59.2708-21/61094098_1175864839273132_9040516703330500608_n.pdf/SKIDMORE-NURSING-DRUG-REFERENCE-Linda-Skidmore-Roth-Mosbys-2019-Nursing-Drug-Reference-E-Book-Mosby-2018.pdf?_nc_cat=103&ccb=1-5&_nc_sid=0cab14&_nc_eui2=AeHp62Lo7zPLjS4ZTANbv4KtIYnobBxr62ghiehsHGvraJmqWGifW2SgzdehpYqvvs-i8ruLhoCi08VPKROQ15LE&_nc_ohc=SCSu2woPrdEAX9iHX7i&_nc_oc=AQkO07Sgw5xRUGYshjA_PTpbzASHh8k_C7Jwch3t6PTJUrUq0YOYOoER7fYYLc0G_JP7qwgWWu9gFoSw3AA2EI9n&_nc_ht=cdn.fbsbx.com&oh=55e9a5a50d56fc3434d869768d5cf664&oe=614507B6&dl=1