Metoprolol tartrate



Metoprolol tartrate
QUESTION
Select a medication used for the treatment of newly diagnosed hypertension, chronic hypertension, or malignant hypertension, other than a diuretic. Share the mechanism of action of this medication and hints for monitoring, side effects, and drug interactions, including CAM, of which one should be aware. Discuss how ethnic, genetic, or cultural differences affect how you treat the patient and explain any adverse effects or drug interaction associated with the agents used to treat cardiovascular disease. Give examples of how you would modify your approach based on these factors. Include the name of the medication in the subject line so that the medications can be followed. Include references using APA format.
Metoprolol tartrate

ANSWER
Topic 5 DQ 2

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Topic 5 DQ 2
Metoprolol tartrate is a Beta- blocker and works by reducing the heart rate and the blood output, thereby reducing blood pressure and hypertension (Farzam & Jan, 2021). Mechanism of Action: Metoprolol tartrate primarily acts by competitively blocking the beta-1-adrenergic receptors on cardiac cells and has a negligible effect on the beta-2 receptor cells. Monitoring at baseline: Maximum serum concentration reaches after an hour of oral administration and twenty minutes of intravenous administration. Monitor effectiveness of oral administration through heart rate rhythm and blood pressure, intravenous dose using blood pressure, heart rate, electrocardiogram, and the pulse frequently during dose adjustment to titrate a higher or lower dose and during therapy (Morris & Dunham, 2022). Side effects include fatigue, depression, dizziness, nausea, decreased exercise tolerance, decreased glucose tolerance, and may hide hypoglycemia and diarrhea (Farzam & Jan, 2021). Adverse effects include heart failure, block, and bronchospasm (Morris & Dunham, 2022). Drug interactions: licorice, alcohol, and St, John’s wort. The drug works well with food.
Ethnic differences: Beta-blockers risk an increase in gout-related medication and a rise in serum uric acid in African American adults compared to angiotensin-converting enzyme (ACE) inhibitor drugs and dihydropyridine calcium-channel blockers (CCBs) (Juraschek et al., 2017). Clinicians should thus treat African American patients with kidney disease with a diuretic or an ACE inhibitor as initial therapy and CCBs for those that do not have kidney disease. Genetic differences: Patients with (A;A), (C;C), and (G;C) genotypes have a greater reduction of pressure using Metoprolol (“Metoprolol,” 2022). Individuals with Cytochrome P450 2D6 and have (A;A) genotypes have reduced metabolism of Metoprolol. Genetic variants of CYP2D6 influence the dose titration and have an increased risk of slow heart rate. Metoprolol is also contraindicated in individuals over sixty years due to their physiologic changes. Additionally, it is contraindicated in individuals with sick sinus syndrome, lack a peacemaker, have low blood pressure, and have documented adverse reactions to the drug.
There is no known drug interaction with any cardiovascular drug, but Metoprolol may increase the hypotensive activities of any prescribed cardiovascular medication like Moexipril. A healthcare provider should thus titrate the Metoprolol dose based on monitoring results of blood pressure, ECG reading, heart rhythm, and pulse.  
References
Farzam, K., & Jan, A. (2021, March 12). Beta blockers – StatPearls – NCBI bookshelf. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK532906/
Juraschek, S. P., Appel, L. J., & Miller, E. R. (2017). Metoprolol increases uric acid and risk of gout in African Americans with chronic kidney disease attributed to hypertension. American Journal of Hypertension, 30(9), 871-875. https://doi.org/10.1093/ajh/hpx113
Metoprolol. (2022, May 24). DrugBank Online | Database for Drug and Drug Target Info. https://go.drugbank.com/drugs/DB00264
Morris, J., & Dunham, a. (2022, January 19). Metoprolol – StatPearls – NCBI bookshelf. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK532923/

Metoprolol tartrate


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