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