NATIONAL
CALIFORNIA
VENTURA
category
mechanism
- Selective inhibitor of Beta-1 receptors - competitively blocks Beta-1, with little or no effect on Beta-2 receptors
indications
- Atrial fibrillation or atrial flutter for acute ventricular rate control
contraindications
- Sick sinus syndrome (except in patients with a functioning artificial pacemaker)
- Second- or third-degree AV block (except in patients with a functioning artificial pacemaker)
- Administration with, or within a few hours of the administration of IV calcium channel blockers
dosing
IV: 2.5 to 5 mg over 2 minutes; repeat dose every 5 minutes as needed; maximum total dose: 15 mg
administration
IV: May administer undiluted IV push over 1 minute for acute treatment
onset
IV: ~20 minutes
duration
4-6 hours
notes
- Hypoglycemia: Beta-blockers may worsen, prolong, or cause hypoglycemia. Additionally, beta-blockers may mask symptoms of hypoglycemia (tremor, irritability, palpitations), making diaphoresis the only symptom unaffected by beta-blockers
- Withdrawal: Beta-blocker therapy should be gradually tapered to avoid acute tachycardia, hypertension, and/or ischemia
dosage form
Solution, Intravenous: 5 mg/5 mL (5 mL)
brand name
Lopressor
adverse reactions
- Bradyarrhythmias
- May cause bradycardia, sinus pause, first-degree atrioventricular (AV) block, second-degree atrioventricular block, or complete heart block
- Bronchospasm
- May cause bronchospasm but selective beta-blockers (ie Beta-1 specific) like metoprolol have a lower risk of bronchospasm
- CNS effects
- May cause fatigue, sleep disturbance, insomnia
structure