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Toprol XL

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NURS 1566 Clinical Form 3: Clinical Medications Worksheets (You will need to make additional copies of these forms) Generic Name Trade Name Metoprolol Toprol-XL Classification Dose Route Time/frequency Antianginals, 25 mg PO BID antihypertensives Peak Onset Duration Normal dosage range Unknown 15 min 6-12 hr 25-100 mg/day as a single dose initially or 2 divided doses, may be increases q 7 days as needed up to 450 mg/day (for angina give in divided dose). Why is your patient getting this medicati
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  NURS 1566 Clinical Form 3: Clinical Medications Worksheets (You will need to make additional copies of these forms)Generic NameMetoprololTrade NameToprol-XLClassificationAntianginals,antihypertensivesDose25 mgRoutePOTime/frequencyBIDPeak UnknownOnset15 minDuration6-12 hr  Normal dosage range25-100 mg/day as a single dose initially or 2 divided doses,may be increases q 7 days as needed up to 450 mg/day (for angina give in divided dose).Why is your patient getting this medicationTreatment of AnginaFor IV meds, compatibility with IV drips and/or solutions N/AMechanism of action and indications(Why med ordered)Blocks stimulation of beta 1, adrenergic receptors. Doesnot usually affect beta 2 adrenergic receptor sites. Nursing Implications (what to focus on) Contraindications/warnings/interactionsUncompensated CHF. Pulmonary edema. Cardiogenic shock.Bradycardia or heart block.Common side effectsFatigue, weakness, anxiety, depression, dizziness,drowsiness, insomnia, memory loss, bradycardia,hypotension.Interactions with other patient drugs, OTC or herbalmedicines (ask patient specifically)Hypotension may occur with other antihypertensives.Concurrent administration of thyroid administration maydecrease effectiveness.Lab value alterations caused by medicineMay cause increase BUN, serum lipoprotein, potassium,triglyceride, and uric acid levels. May cause increase ANAtiters, May cause increase in blood glucose levels, may causeincrease serum alkaline phosphatase, LDH, AST, and ALTlevels.Be sure to teach the patient the following about thismedicationTake as directed, at the same time each day, even if feelingwell, do not skip or double up on missed doses. Do not stopmedication suddenly. Teach patient and family how to take pulse daily and blood pressure biweekly. May causedrowsiness. Change positions slowly. Nursing Process- Assessment (Pre-administration assessment)Take apical pulse before administering If <50bpm or if arrhythmia occurs withholdmedication& notify Dr. Assessment Why would you hold or not give thismed?Apical pulse < 50 BPM Evaluation Check  after givingMonitor BP, Reduction if frequency of angina attacks,increase in activity tolerance.
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