HealthCare

Metoprolol is a beta blocker type of drug. It is the prototype of cardio selective blockers. It blocks cardiac stimulation similar to propranolol but is less likely to worsen asthma. But Metoprolol is not entirely safe. It may also be preferred to propranolol in diabetics receiving insulin or oral hypoglycaemics.It is used for the treatment of Hypertension, angina pectoris and acute myocardial infarction.

It is available under the brand names Lopressor  -metoprolol tartrate  and Toprol XL - metoprolol Succinate from Mylan . Other brand or generic formulations of this medication may also be available.

Adults are administered  100-200 mg in two divided doses for Children:  1-5 mg/kg/day in two divided doses. Metoprolol is contra indicated in Bradycardia, cardiogenic shock, 2nd or 3rd degree A.V. block, cardiac failure. Verapamil therapy and Asthma/COPD. Special Precautions should be taken during General anaesthesia, pregnancy and reduced cardiac reserve. In Pregnanant women Metoprolol May effect the foetus and during  Lactation: it may pass in breast milk. Hence use only if clearly indicated.

 
  Side-effects of Metoprolol inlcude headache, nightmares, hypotension, eye and skin reactions. The Drugs that interact are: Cimetidine which potentiate metoprolol and it has negative ionotropic effect with general anesthetics. Bioavailability is increased by food and there is enhancement of antihypertensive effect with    diuretics and vasodilators. Metoprolol is very useful in combination with digitalis.

Metoprolol is available under the brand names Lopressor and Toprol XL. Other brand or generic formulations of this medication may also be available.

Common brands  are

Lopressor 50 mg--pink, capsule-shaped, scored tablets
Lopressor 100 mg--light-blue, capsule-shaped, scored tablets
Toprol XL 50 mg extended-release tablets--white, round, film-coated, scored tablets
Toprol XL 100 mg extended-release tablets--white, round, film-coated, scored tablets

DIGOXIN is a CARDIAC  GLYCOSIDES type of drug. It has direct effects on myocardial contractility and electrophysiological conduction properties i.e. 1. Negative chronotropic effect (Reduces heart rate & A.V. conduction). 2. Positive inotropic effect i.e. there is a dose dependent increase in force of contraction of myocardium. The above two effects thereby make it an ideal drug for treatment of cardiac failure of diverse aetiologies without increasing the oxygen demand of the failing myocardium. There is also a mild direct vasoconstrictor action thereby increasing peripheral resistance mildly. Diuresis is seen promptly in C.H.F. patients owing to improved renal perfusion which was previously compromised but at times an addition of diuretic may be considered to improve the patients hypoxic and hypervolemic condition rapidly if need arises.

DIGOXIN is used in Congestive heart failure, cardiac tachyarrhythmias (Paroxysmal supraventricular tachycardia, atrial flutter & fibrillation). Dosage : Initially 0.25-1.5 mg daily. Maint; 0.25-0.5 mg daily. For Children : initially 10-20 meg/kg body wt. 6 hrly. Maint 10-20 meg/kg body wt. in single or divided doses daily. 

Contra-lndicatlons of DIGOXIN : Hypokalemia, ventricular tachycardia, partial A.V.    block, acute myocarditis. Wolf-Parkinson-White Syndrome. Special Precautions has to be taken in Elderly, renal or severe hepatic disease, myocardial infarction and  thyrotoxi-cosis patients.

Common Side-effects that can be expected with DIGOXIN are Anorexia, nausea, vomiting, ab¬dominal pain, fatigue, headache, mental confusion, restlessness.

PROPRANOLOL is a BETA  BLOCKERS group of medicines for heart ailments. It decreases heart rate, force of contraction & cardiac output. On prolonged administration BP gradually falls in hypertensives but not in normotensives.

PROPRANOLOL is used in Hypertension, angina pectoris, cardiac arrhythmias, post M.I. tachycardia,migraine and anxiety. the common  Dosage is 10 mg B.D. to 160 mg Q.I.D (average 40-160 mg/day)

Contra-lndicatlons of PROPRANOLOL are Obstructive COPD like asthma. Partial or complete heart block, C.H.F. Acute M.I. Cardiogenic shock and those taking Digitalis & verapamil therapy.

Special Precautions have to be taken while taking PROPRANOLOL in Impaired renal & hepatic functions, pregnancy, cardiac failure. Myocardial insufficiency and  reduced cardiac reserve. Side-effects include Tiredness, lack of drive, G.I. upsets, nightmares, forgetfulness, rare cases of  hallucinations, muscle fatigue.

PROPRANOLOL can interact with other drugs and can cause Hypertension & bradycardia with adrenaline, reduced heart rate & output with anaesthetic agents. Also Severe bradycardia may occur with digitalis and calcium channel blockers. PROPRANOLOL causes elevated blood levels with cimetidine .

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