Metoprolol
| Drug | Metoprolol |
| Brand names | Dutoprol ®, Kapspargo ®, Lopressor ®, Lopressor HCT ®, Toprol ®, Seloken ® |
| Indications | Myocardial ischemia. Perioperative hypertension. |
| Mechanism of action | Beta-1 adrenergic blocker. |
| Effects | Lowers blood pressure, reduces heart rate, myocardial oxygen consumption and myocardial contractility. Less pronounced blood pressure lowering effect than esmolol and labetalol. |
| Time to onset of action | 20 minutes |
| Duration of action | 5 to 8 hours |
| Delivery | IV |
| Dose | 1.25 to 5 mg IV followed by 2.5–15 mg IV every 3 to 6 hours. |
| Adverse effects | Vomiting. Dizziness. Nausea. Atrioventricular blocks (AV blocks). Orthostatic hypotension. Paresthesias (scalp tingling). Bronchospasm. |
| Caution | • Avoided in hypertensive emergencies with acute heart failure. • Used cautiously in patients with asthma (due to risk of bronchospasm). • Used cautiously in bradycardia due to negative chronotropic effect. |