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also known as Trandate normodyne
Alpha1 blocking agent vasodilation , decreased peripheral vascular resistance , orthostatic hypotension
nonselective blocking agent effects the SA, AV , ventricular muscle =bradycardia , delay in AV conduction , depressed cardiac contractility
More potent Beta Blocker than Alpha Blocker= BP reduces without reflex tachycardia
Indication #1 Hypertensive emergencies
Indication #2 All patients with suspected MI and unstable angina (if not contraindicated)
Indication #3 Useful as adjunctive agent with fibrinolitic therapy (may reduce nonfatal re-infaction and recurrent ischemia)
Indication #4 To convert SVT (re-entry SVT , Afib, A flutter with RVR) to NRS or to slow ventricular response
Indication #5 To reduce myocardial ischemia in AMI patients with elevated HR,BP or both
Class Beta blocker
Contraindications -Bronchial asthma -Uncompensated CHF -High Degree Heart Blocks (2nd and 3rd degree) -Cardiogenic Shock -Severe Bradycardia -Pulmonary Edema -Hypersensitivity
Side effects CNS Anxiety ,Dizziness , Fatigue/Malaise , Headache ,Tremors ,Mental depression , Drowsiness ,Nightmares , Scalp tingling Side effects
Side effects CV AVblocks-LT, bradycardia , Chest pain ,CHF-LT, Orthostatic hypotension ,ventricular dysrhythmias-LT, palpatations, peripheral edema , pulmonary edema , Coldextremities
Side effects EENT double vision , dry burning eyes , sore throat , tinnitus , visual changes
Side effects GI Diarrhea-C, Nausea -C, vomiting , Constipation , Taste disturbances
Side effects GU Dysuria ,Ejaculatory Failure , Impotence
Side effect HEME Agranulocytosis-LT
Side effects RESP Bronchospasms-LT , dyspnea , wheezing
Side effect MS Muscle cramps
Side effects SKIN Fever , Pruritus , Rash , Uticaria
Precaution - use with caution in -COPD patients (nonallergic -bronchospastic disease) -Well-compensated patients with hx of heart failure -Pheochromocytoma -Impaired hepatic function -Impaired renal function ..... -Jaundice -Diabetes mellitus -Peripheral Vascular Disease -Thyroid disease -Nitroglycerin my augment hypotensive effects
How supplied 5 mg / ml (4,8,20,40 ml vials)
Administered SLOW IVPand IV infusion
Initial Dose 10mg SLOW IVP (over 1-2 minutes)
Subsequent dose 10 to 20 mg every 10 minutes , prn
Total dose 150 mg
IV infusion dose: MIX 200mg/250cc
IV infusion dose : INFUSE AT 2 to 8mg/ minute (Titrate to supine blood pressure)
Created by: bandam17