Lopressor injection/adult indications and dosage: Difference between revisions
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===FDA-Labeled Indications and Dosage (Adult)=== | ===FDA-Labeled Indications and Dosage (Adult)=== | ||
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====Myocardial Infarction==== | ====Myocardial Infarction==== | ||
* Upon patient presentation: | * Upon patient presentation: | ||
[[Lopressor injection]] | :: ''[[Lopressor injection]]'' 5 mg IV x 3 boluses at 2-min intervals | ||
* 15 minutes after the full IV dose: | |||
:: ''[[Lopressor tablet]]'' 50 mg PO q6h for 2 days followed by ''[[Lopressor tablet]]'' 100 mg PO q12h | |||
:: or ''[[Lopressor tablet]]'' 25—50 mg PO q6h for 2 days if intolerable to the full IV dose; discontinue [[Lopressor]] in patients with severe intolerance. | |||
[[Lopressor injection]] | [[Lopressor injection]] is indicated in the treatment of [[hemodynamics|hemodynamically]] stable patients with definite or suspected [[acute myocardial infarction]] to reduce cardiovascular [[mortality]] when used in conjunction with [[Lopressor tablet|oral Lopressor]] maintenance therapy. Treatment with [[Lopressor injection]] can be initiated as soon as the patient’s clinical condition allows. | ||
'''Early Treatment''': During the early phase of definite or suspected [[acute myocardial infarction]], initiate treatment with [[Lopressor injection]] as soon as possible after the patient’s arrival in the hospital. Such treatment should be initiated in a coronary care or similar unit immediately after the patient’s [[hemodynamic]] condition has stabilized. Begin treatment in this early phase with the [[intravenous]] administration of three bolus injections of 5 mg of [[Lopressor injection]] each; give the injections at approximately 2-minute intervals. During the [[intravenous]] administration of [[Lopressor]], monitor [[blood pressure]], [[heart rate]], and [[electrocardiogram]]. | |||
In patients who tolerate the full [[intravenous]] dose (15 mg), initiate [[Lopressor tablet]]s, 50 mg every 6 hours, 15 minutes after the last [[intravenous]] dose and continue for 48 hours. Thereafter, the maintenance dosage is 100 mg orally twice daily. Start patients who appear not to tolerate the full [[intravenous]] dose on [[Lopressor tablet]]s either 25 mg or 50 mg every 6 hours (depending on the degree of intolerance) 15 minutes after the last intravenous dose or as soon as their clinical condition allows. In patients with severe intolerance, discontinue Lopressor (see ''[[Lopressor injection/warnings|Warnings]]'').<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = LOPRESSOR (METOPROLOL TARTRATE) INJECTION, SOLUTION [NOVARTIS PHARMACEUTICALS CORPORATION] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=6640cc61-edee-4808-a26f-cbc2c0b7af86#nlm34067-9 | publisher = | date = | accessdate = }}</ref> | |||
===Off-Label Use and Dosage (Adult)=== | |||
==== | ====Cardiac Dysrhythmia==== | ||
[[Lopressor injection]] (range: 2—15 mg) has been shown to be effective in the treatment of [[atrial flutter]], [[atrial fibrillation]], [[multifocal atrial tachycardia]], and [[supraventricular tachycardia]].<ref name="Amsterdam-1991">{{Cite journal | last1 = Amsterdam | first1 = EA. | last2 = Kulcyski | first2 = J. | last3 = Ridgeway | first3 = MG. | title = Efficacy of cardioselective beta-adrenergic blockade with intravenously administered metoprolol in the treatment of supraventricular tachyarrhythmias. | journal = J Clin Pharmacol | volume = 31 | issue = 8 | pages = 714-8 | month = Aug | year = 1991 | doi = | PMID = 1880230 }}</ref> | |||
====Injection Site Pain Associated with Propofol==== | |||
==== | Pretreatment with [[Lopressor injection]] (2 mg IV) was shown to be equally as effective as [[lidocaine]] in reducing the pain associated with [[propofol]] injection.<ref name="Aşik-2003">{{Cite journal | last1 = Aşik | first1 = I. | last2 = Yörükoğlu | first2 = D. | last3 = Gülay | first3 = I. | last4 = Tulunay | first4 = M. | title = Pain on injection of propofol: comparison of metoprolol with lidocaine. | journal = Eur J Anaesthesiol | volume = 20 | issue = 6 | pages = 487-9 | month = Jun | year = 2003 | doi = | PMID = 12803269 }}</ref> | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Latest revision as of 13:13, 21 March 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
FDA-Labeled Indications and Dosage (Adult)
Myocardial Infarction
- Upon patient presentation:
- Lopressor injection 5 mg IV x 3 boluses at 2-min intervals
- 15 minutes after the full IV dose:
- Lopressor tablet 50 mg PO q6h for 2 days followed by Lopressor tablet 100 mg PO q12h
- or Lopressor tablet 25—50 mg PO q6h for 2 days if intolerable to the full IV dose; discontinue Lopressor in patients with severe intolerance.
Lopressor injection is indicated in the treatment of hemodynamically stable patients with definite or suspected acute myocardial infarction to reduce cardiovascular mortality when used in conjunction with oral Lopressor maintenance therapy. Treatment with Lopressor injection can be initiated as soon as the patient’s clinical condition allows.
Early Treatment: During the early phase of definite or suspected acute myocardial infarction, initiate treatment with Lopressor injection as soon as possible after the patient’s arrival in the hospital. Such treatment should be initiated in a coronary care or similar unit immediately after the patient’s hemodynamic condition has stabilized. Begin treatment in this early phase with the intravenous administration of three bolus injections of 5 mg of Lopressor injection each; give the injections at approximately 2-minute intervals. During the intravenous administration of Lopressor, monitor blood pressure, heart rate, and electrocardiogram.
In patients who tolerate the full intravenous dose (15 mg), initiate Lopressor tablets, 50 mg every 6 hours, 15 minutes after the last intravenous dose and continue for 48 hours. Thereafter, the maintenance dosage is 100 mg orally twice daily. Start patients who appear not to tolerate the full intravenous dose on Lopressor tablets either 25 mg or 50 mg every 6 hours (depending on the degree of intolerance) 15 minutes after the last intravenous dose or as soon as their clinical condition allows. In patients with severe intolerance, discontinue Lopressor (see Warnings).[1]
Off-Label Use and Dosage (Adult)
Cardiac Dysrhythmia
Lopressor injection (range: 2—15 mg) has been shown to be effective in the treatment of atrial flutter, atrial fibrillation, multifocal atrial tachycardia, and supraventricular tachycardia.[2]
Injection Site Pain Associated with Propofol
Pretreatment with Lopressor injection (2 mg IV) was shown to be equally as effective as lidocaine in reducing the pain associated with propofol injection.[3]
References
- ↑ "LOPRESSOR (METOPROLOL TARTRATE) INJECTION, SOLUTION [NOVARTIS PHARMACEUTICALS CORPORATION]".
- ↑ Amsterdam, EA.; Kulcyski, J.; Ridgeway, MG. (1991). "Efficacy of cardioselective beta-adrenergic blockade with intravenously administered metoprolol in the treatment of supraventricular tachyarrhythmias". J Clin Pharmacol. 31 (8): 714–8. PMID 1880230. Unknown parameter
|month=ignored (help) - ↑ Aşik, I.; Yörükoğlu, D.; Gülay, I.; Tulunay, M. (2003). "Pain on injection of propofol: comparison of metoprolol with lidocaine". Eur J Anaesthesiol. 20 (6): 487–9. PMID 12803269. Unknown parameter
|month=ignored (help)