Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Metoprolol is a beta-adrenergic blocking
agent that is used for treating high blood pressure, heart pain,
abnormal
rhythms of the heart, and some neurologic conditions. Examples of
beta-adrenergic blockers include propanolol (Inderal), atenolol (Tenormin), and
timolol (Blocadren). Metoprolol blocks the action of the sympathetic nervous
system, a portion of the involuntary nervous system, by blocking beta receptors
on sympathetic nerves. Since the sympathetic nervous system is responsible for
increasing the rate with which the heart beats, by blocking the action of these
nerves metoprolol reduces the heart rate and is useful in treating abnormally
rapid heart rhythms.
Metoprolol also reduces the force of contraction of heart
muscle and thereby lowers blood pressure. By reducing the heart rate and the
force of muscle contraction, metoprolol reduces the need for oxygen by heart
muscle. Since heart pain (angina
pectoris) occurs when oxygen demand of the
heart muscle exceeds the supply of oxygen, metoprolol, by reducing the demand
for oxygen, is helpful in treating heart pain. The FDA approved metoprolol in
August 1978.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 25, 50, and 100 mg. Tablets (extended release):
25, 50, 100, and 200 mg. Injection: 1 mg/ml
STORAGE: Tablets should be stored between 15-30 C (59-86 F). They
should be protected from moisture and dispensed in tight, light-resistant
container.
PRESCRIBED FOR: Metoprolol is prescribed for patients with high blood
pressure (hypertension). It is also used to treat chest pain (angina pectoris)
related to coronary artery disease. Metoprolol is also useful in slowing and
regulating certain types of abnormally rapid heart rates (tachycardias). Other
uses for metoprolol include the prevention of
migraine headache and the
treatment of certain types of tremors (familial or hereditary essential
tremors).
DOSING: Metoprolol should be taken before meals or at bedtime. The
dose for treating hypertension is 100-450 mg daily in single or divided doses.
Angina is treated with 100-400 mg daily in two divided doses. Acute myocardial
infarction is treated with three 5 mg injections administered 2 minutes apart
followed by treatment with 50 mg oral metoprolol every 6 hours for 48 hours.
After 48 hours, patients should receive 100 mg orally twice daily for at least 3
months.
DRUG INTERACTIONS: Calcium channel blockers and digoxin (Lanoxin) can
lower of blood pressure and heart rate to dangerous levels when administered
together with metoprolol.
Metoprolol can mask the early warning symptoms of low blood sugar
(hypoglycemia) and should be used with caution in patients receiving treatment
for diabetes.
PREGNANCY: Safe use of metoprolol during
pregnancy has not been
established.
NURSING MOTHERS: Small quantities of metoprolol are excreted in
breast
milk and may potentially cause adverse effects in the infant.
High blood pressure, also known as hypertension, is a repeatedly
elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above
140 with a diastolic pressure above 90. There are two causes of high blood pressure, primary and secondary. Primary high blood pressure is much more common that secondary and its basic causes or underlying defects are not always known. It is known that a diet high in salt increases the risk for high blood pressure, as well as high cholesterol. Genetic factors are also a primary cause. Secondary high blood pressure is generally caused by another condition such as renal hypertension, tumors, and other conditions. Treatment for high blood pressure is generally lifestyle changes and if necessary, diet.
Dizziness is a symptom that is often applies to a variety of sensations including lightheadedness and vertigo. Causes of dizziness include low blood pressure, heart problems, anemia, dehydration, and more. Treatment of dizziness depends on the cause.
Migraine is usually periodic attacks of headaches on one or both sides of the head. These may be accompanied by nausea, vomiting, increased sensitivity of the eyes to light (photophobia), increased sensitivity to sound (phonophobia), dizziness, blurred vision, cognitive disturbances, and other symptoms. Treatments for migraine headache include therapies that may or may not involve medications.
Angina is chest pain that is due to an inadequate supply of oxygen to the heart muscle.
Angina can be caused by coronary artery disease or spasm of the coronary
arteries. EKG, exercise treadmill, stress echocardiography, stress thallium, and cardiac
catheterization are important tests used in the diagnosis of angina.
Hyperthyroidism is an excess of thyroid hormone resulting from an overactive thyroid gland. Symptoms can include increased heart rate, weight
loss, depression, and cognitive slowing. Treatment is by medication, the use of
radioactive iodine, thyroid surgery, or reducing the dose of thyroid hormone.
Fainting, also referred to as blacking out, syncope, or temporary loss of consciousness has many causes. Often a person will have signs or symptoms prior to the fainting episode. Diagnosis and treatment depends upon the cause of the fainting or syncope episode.
Heart attack happens when a blood clot completely obstructs a coronary
artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical
instability of the heart.
Raynaud's phenomenon is characterized by a pale-blue-red sequence of color changes of the digits, most commonly after exposure to cold. Occurring as a result of spasm of blood vessels, the cause is unknown. Symptoms of Raynaud's phenomenon depend on the severity, frequency, and duration of the blood vessel spasm. Treatments include protection of the digits, medications, and avoiding emotional stresses, smoking, cold temperature, and tools that vibrate the hands.
Abdominal aortic aneurysm is a ballooning or widening of the main artery (the aorta) as it courses down through the abdomen. The most common cause of aortic aneurysms is
"hardening of the arteries" called arteriosclerosis.
Mitral valve prolapse (MVP) is also also known as "click murmur syndrome" and "Barlow's syndrome." Mitral valve prolapse is the most common heart valve abnormality. Signs and symptoms of mitral valve prolapse include: fatigue, palpitations, chest pain, anxiety, and migraine headaches. Echocardiography is the most useful test for mitral valve prolapse. Most patients do not need any treatment, however, patients with severe prolapse may need treatment.
There are many types of thyroid disease. Some occur due to the function of the thyroid itself such as hypothyroidism, hyperthyroidism, Hashimoto's thyroiditis, etc. Some causes of thyroid disease occur due to problems with the structure of the thyroid gland such as goiters, thyroid nodules, and thyroid cancer. Treatment of thyroid disease depends on the cause of the disease.
Tremor is the involuntary movements of one or more parts of the body. Causes of tremor include neurological disorders, neurodegenerative diseases, drugs, mercury poisoning, overactive thyroid and liver failure. There are several types of tremor. Treatment depends upon the type of tremor and availability of medications for the condition.
Heart rhythm disorders vary from minor palpitations, premature atrial contractions (PACs), premature ventricular contractions (PVCs), sinus tachycardia, and sinus brachycardia, to abnormal heart rhythms such as tachycardia, ventricular fibrillation, ventricular flutter, atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia (PSVT), Wolf-White-Parkinson syndrome, brachycardia, or heart blocks. Treatment is dependant upon the type of heart rhythm disorder.
Heart disease (coronary artery disease) is caused by a buildup of cholesterol deposits in the coronary arteries. Risk factors for heart disease include smoking, high blood pressure, heredity, diabetes, peripheral artery disease, and obesity. Symptoms include chest pain and shortness of breath. There are a variety of tests used to diagnose coronary artery disease. Treatment includes life-style changes, medications, procedures, or surgery.
High blood pressure (hypertension) means high pressure (tension) in the arteries. Treatment for high blood pressure include lifestyle modifications (alcohol, smoking, coffee, salt, diet, exercise), drugs and medications such as ACE inhibitors, angiotensin receptor blockers, beta blockers, diuretics, calcium channel blockers (CCBs), alpha blockers, clonidine, minoxidil, and Exforge.
Aortic dissection is a small tear in the large blood vessel that leads from the heart and supplies blood to the body. There are two types of aortic dissection, type 1 and type 2. Signs and symptoms of aortic dissection include a tearing or ripping pain, nausea, sweating, weakness, shortness of breath, sweating, or fainting. Treatment depends on the type of aortic dissection, and the severity of the tear in the aorta.
Raynaud's phenomenon (RP) is a condition resulting in a particular series of discolorations of the fingers and/or the toes after exposure to changes in temperature (cold or hot) or emotional events.
Skin discoloration occurs because an abnormal spasm of the blood vessels causes
a diminished blood supply to the local tissues. Initially, the digit(s) involved turn white
because of the diminished blood supply. The digit(s) then turn blue because of
prolonged lack of oxygen. Finally, the blood vessels reopen, causing a
local "flushing" phenomenon, which turns the digit(s) red. This three-phase color sequence
(white to blue to red), most often upon exposure to cold temperature, is characteristic of RP.
Raynaud's phenomenon most frequently affects women,
especially in the second, third, or fourth decades of life. People can have Raynauds phenomenon alone or as a part of other rheumatic diseases. When it
occurs alone...
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