Question | Answer |
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) |