Free Youtube Drug review video for studying!
Youtube what is going on welcome back to another video with the opera nurse and today we are going to be talking about the medication metoprolol aka low pressure this is a beta blocker so let’s go ahead and get started and we’re going to begin with the action what is expected when a patient is taking metoprolol okay so metoprolol what it does it block stimulations
Stimulation of the beta-1 adrenergic receptors and these are receptors that are typically found um on a heart these are myocardial receptors so what that ends up doing is that the enz that ends up decreasing blood pressure and the heart rate it can decrease the frequency of angina pectoris and it can decrease the rate of cardiovascular mortality and hospitalization
Hospital hospitalization and patience with heart failure as you can see this is all one take i don’t edit my videos so let’s talk about complications side effects adverse effects they include feet uh fatigue weakness erectile dysfunction bradycardia heart failure or pulmonary edema blurred vision hyperglycemia hypoglycemia drug induced hepatitis bronchospasm
And or wheezing so these are all some of these are common and somebody’s a little more severe for the medication administration you can go ahead and pause the video now and look at what the medication administration looks like uh this man this meant can be given orally or iv so you can go ahead and pause here but we’re going to move on to the next slide and
We’re going to talk about contraindications this drug metoprolol is contraindicated in patients with uncompensated heart failure pulmonary edema cardiogenic shock bradycardia heart block or sick sinus syndrome you want to use this drug cautiously in patients with renal impairment or hepatic impairment for our geriatrics uh we want to be cautious using this drug
With them because they have an increased sensitivity to beta blockers um and also because they have pulmonary or they can’t have pulmonary disease and diabetes which can mask the sign of hypoglycemia and we also even though the safety is not established for our ob patients it does cross the placenta so it could potentially cause fetal and neonatal bradycardia
Hypotension hypoglycemia or respiratory depression these are all very very big things and can affect the um the neonate so we will you know we would have to be cautious when giving metoprolol for these patients i’m just kind of thinking up top i was i would assume a reason why we would give a patient an ob patient metoprolol is if she if she is experiencing like
Elevated um blood pressure due to maybe or things like that so but um just kind of thinking out loud on that one so for interactions drug to drug uh anesthesia iv uh phenophenia may cause increased myocardial depression there’s an increased risk of bradycardia when used with digestion or clonidine for example other direct drug uses increase hypotensive with
Other anti-hypertensive agents other drugs drug uses with stimulants like cocaine norepinephrine and ephedrine these may result in excessive hypertension um or even bradycardia if metoprolol is combined with thyroid um the effectiveness of the drug may decrease and it can also alter the effectiveness of insulins and other oral hypoglycemic agents and finally it
May decrease the beneficial beta-1 cardiovascular effects of dopamine and delbutamine so there’s quite a bit there and there’s a lot there with nursing interventions we want to monitor blood pressure their ecg impulse we want to make sure that they are compliant with the medication so we’re monitoring their frequency of prescription refills uh again we talked
About looking at the ecg we want to do this every five to 15 minutes as well as monitoring their vital signs we’re going to administer atrophine if their heart rate is less than 40 beats per minute and their cardio um their cardiac output is decreased we want to monitor their eyes and o’s and their daily weights we’re going to assess for science and symptoms
Of heart failure so we’re looking at uh dyspnea we’re looking at crackles rails and a lot in the lungs um again we’re looking at weight gain which is why we’re monitoring our eyes and nose and getting daily weights uh we’re checking peripheral edema and we’re looking at um jvd or jugular uh distinction we’re going to check labs due to the fact that it can cause
An increase in the bun potassium uric acid levels serum lipoprotein and triglyceride we also want to check glucose levels because they can increase as we talked about before we’re going to check a and a titers and we want to check liver enzymes because again they can increase so we’re looking at alt ast we don’t want those values to be too high or higher than
Normal for client education there is quite a few we really want to educate our patient to take um as directed take it the same day don’t skip or double up and take this doses as soon as possible up to eight hours before the next dose because abrupt withdrawal can be life threatening we want to teach the patient how to check their pulse daily and their blood
Pressure bi-weekly and report any significant changes to the health care professional we want to inform them that it can cause drowsiness so we don’t want them to drive orthostatic hypertension is import is a big thing here so they need to change positions slowly when they are getting up getting out of bed um and it can cause this drug can also cause increased
Sensitivity to clothes so it can make you feel a little bit colder i’m going to get them to avoid a lot of coffee teas and cola like we said earlier diabetics need to monitor their blood glucose uh they should we should inform them to notify the healthcare professional if there is a slow pulse they have difficulty breathing wheezing um their extremities are
Cold if they have if they feel dizzy if they’re confused they feel depressed they have any rash fever bruising or if any bleeding occurs female patients need to notify their healthcare professional if they’re pregnant or if they’re planning to get pregnant because we want to monitor for neonatal hypotension hypoglycemia bradycardia and respiratory depression
And we talked about that earlier and we want to reinforce the need for to continue additional therapies for hypertension so again you know we want to get them to to lose weight if they have to lose weight we want to restrict their sodium intake we want to again we want to get them to exercise we want them to reduce their stress limit alcohol and probably most
Importantly stop smoking some extra notes related to metoprolol it is a cardiac med so we need to take an applicable pulse before we give it and if it’s less than 50 bpm then we’re gonna hold it and notify the healthcare professional uh we can give with meals or after they eat uh we can do an iv push and it has to be done over one minute and we want to have a
Second practitioner check the order and the dosage calculation before we are giving it iv and for evaluation again decrease in blood pressure we want to decrease the blood pressure with beta blockers uh reduction in the frequency of anginal attacks attacks increase in activity tolerance and the prevention of myocardial infarction and that is the end of metoprolol
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Transcribed from video
Metoprolol By John Azike JrliveBroadcastDetails{isLiveNowfalsestartTimestamp2021-02-18T050015+0000endTimestamp2021-02-18T051209+0000}
