Level 3

relatively selective beta blocker with no intrinsic sympathomimetic activity.

available in oral form as an immediate release or sustained release in
increments of 25mg.
It is also available as an IV formulation usually 1mg/ml

It produces
decreases in heart rate and cardiac output and myocardial oxygen consumption.

Whilst it does have some β 2 action it has little or no effect on these receptors
at doses less than 100mg

- Withdrawal

- Care with: Opioids, Halo, OAD, CCB

- Use with Ca Channel blockers may result in complete heart block

lipid solubility is high so it crosses the BBB

10-20% to albumin

5.5 L/Kg

hepatic or renal Extensively hepatic via CYP2D6

urine 5-10% unchanged

3-8hours

PO or IV
dose Orally in 12.5mg increments, IV in 1-2mg boluses

Beta Blocker

- Early use of metoprolol in haemodynamically stable myocardial infarction reduces infarct size and incidence of VF.
- rate control in atrial fibrillation
- hypertension

Beta blockage leads to ↓Gs activity in receptor associated organs and
associated ↓in adenylyl cyclase and intracellular Ca2+.

bioavailabilty Absoption is rapid and complete, however there is extensive first pass metabolism bioavailability = 50%

Antiarrhythmic –
Vaughan Williams Class II
Beta blocker

- Early use of metoprolol in haemodynamically stable myocardial infarction reduces infarct size and incidence of VF.
- rate control in atrial -fibrillation
- hypertension

Beta blockage leads to ↓Gs activity in receptor associated organs and
associated ↓ in adenylyl cyclase and intracellular Ca2+.

bioavailabilty Absoption is rapid and complete, however there is extensive fi¬rst pass metabolism bioavailability = 50%