Time：2023-04-01 04:39:18 source：psychiatricethics.com author：Emergency treatment Read：167次

There were two "pits" when taking metoprolol, he stepped on both, everyone should learn from it

Hua Zi knew an uncle Wang who was an old patient with high blood pressure for many years. A few months ago, the doctor helped him adjust his medication and added metoprolol to the antihypertensive plan. As a result, Uncle Wang stepped on the two "pits" that were easy to encounter when taking metoprolol. Shortly after adjusting the medication, Uncle Wang developed symptoms of dizziness and fatigue, and his heart rate was less than 50. Later, it was discovered that Uncle Wang was afraid that the medicine would irritate his stomach, so he did not take the medicine on an empty stomach as the doctor said, but took the medicine after meals. Let Uncle Wang adjust to taking the medicine 1 hour before meals, and the symptoms disappear. After entering the summer, Uncle Wang found that his blood pressure was low, so he arbitrarily proposed to stop metoprolol, but the result was a sudden tachycardia and a sudden rise in blood pressure, which was relieved after going to the hospital for a fluid infusion. He was later put back on metoprolol, but the dose was halved, and his blood pressure has remained stable since then.

I. Metoprolol for reducing heart rate

Metoprolol is a widely used cardiovascular drug, it is a selective beta1-blocker . The β1 receptors in the human body are mainly distributed in the heart. After being blocked by metoprolol, the excitability of the heart can be reduced, the heart rate can be slowed down, the myocardial contractility decreased, the cardiac output decreased, and the blood pressure decreased. Therefore, metoprolol is often used in the treatment of coronary heart disease, angina pectoris, arrhythmia, heart failure, myocardial infarction and other diseases, as well as in the treatment of hypertension.

Second, two "pits" when taking it

1. Taking the drug on an empty stomach: Metoprolol is easily affected by diet when taking it, and food can cause metoprolol Lol's absorption is increased by up to 40%. For a cardiovascular drug, it is very important to maintain a stable blood concentration. Taking the medicine after meals will lead to a large change in the blood concentration, which may lead to the symptoms of "overdose", resulting in adverse reactions such as bradycardia, dizziness, and fatigue. Therefore, metoprolol should be taken on an empty stomach to maintain a stable blood concentration. Fasting usually refers to 2 hours after a meal, or 1 hour before a meal. 2. Slow drug withdrawal: When metoprolol is taken for a long time, the cardiac β1 receptors are blocked, which will result in an increase in the number of β1 receptors and enhanced responsiveness. When the drug is suddenly stopped, the β1 receptor will overreact to the catecholamine hormones produced by the human body, resulting in increased cardiac excitability, increased heart rate, and increased blood pressure. This response is called "drug withdrawal rebound". "Drug withdrawal rebound" is easy to induce cardiovascular and cerebrovascular diseases, which should be avoided as much as possible. Therefore, when taking metoprolol for a long time, the drug should not be suddenly stopped. It takes no less than 2 weeks to slowly reduce the dose and stop the drug. The specific method is to halve the dose every 3 days. When the dose is reduced to the lowest dose, the drug can be discontinued after continuing to take it for 4 days.

Third, the precautions for the two types of metoprolol are different

There are two commonly used dosage forms of metoprolol, one It is metoprolol tartrate tablet, and one is metoprolol succinate sustained-release tablet. The requirements for taking the medicine on an empty stomach mainly refer to metoprolol tartrate tablets. This is an ordinary tablet of metoprolol, which has fast absorption, fast onset and fast metabolism, and is easily affected by diet. Therefore, when taking metoprolol tartrate tablets, take it on an empty stomach. Metoprolol succinate sustained-release tablets will release the drug slowly, which is less affected by diet, and there is no limit to the time of taking it. It can be taken before or after meals. However, both of them have "rebound after withdrawal", and neither can stop the drug suddenly. To sum up, when taking metoprolol, pay attention to the two precautions of taking the medicine on an empty stomach and slowly stopping the medicine, and do not step on the "pit". The drug needs to be used under the guidance of a doctor, be sure to take the medicine according to the doctor's order, and do not change the method of taking the medicine without authorization. If you find any problems during the medication, or have doubts about the medication, you should consult your doctor or pharmacist. I am Huazi, a pharmacist. Welcome to follow me and share more health knowledge.

(责任编辑：Depression)

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