reduce the patient’s blood pressure | My Assignment Tutor

How will metoprolol help to reduce the patient’s blood pressure? (Hint: mechanism ofaction).Metoprolol is a selective beta 1 adrenergic receptor blocker that antagonize the adrenergicsystem in the heart which leading to the decrease In Calcium influx through the calciumchannel and increase in potassium efflux thereby decrease in the sympathetic effect on themyocyte cell thus reducing the heart rate and contractility(Morris & Dunham, 2021).Moreover, Metoprolol on the SA nodal cells block the effect of noradrenaline on the beta 1receptor contributes to decrease in calcium influx and potassium efflux thereby Metoprololdecrease the slope of phase 4 in the nodal action potential and prolongs the repolarisation ofphase 3 (Klabunde, 2016).What adverse reactions should the patient be aware of? Link the adverse reactions to themechanism of action.Bradycardia and hypotension are two common adversary reactions to as Metoprolol decreasethe cardiac output by negative inotropic and chronotropic (Farzam & Jan, 2021). The Nausea,vomiting, abdominal discomfort, dizziness, weakness, headache, fatigue and dry mouth eyesare listed as some other common adverse effects due to the vasodilation (Tucker et al., 2021).In addition, the beta – 1 blocker can mask the hypoglycaemia- induces tachycardia in thediabetic patients (Pietrangelo, 2019).Metoprolol is a negative chronotrope. Explain what this means and link this to the mode ofaction of metoprolol.Chronotropic drugs modify the heart rate and rhythm by affecting the electrical conductionsystem of the heart and the nerves that stimulus it, such as by changing the rhythm producesby the sinoatrial node. Positive chronotropes increase heart rate whereas negativechronotropes decrease heart rate. Therefore, Metoprolol is recognised as a negativechronotrope (BIHS,2017)David remains on metoprolol, but is later also prescribed a calcium-channel blocker. Explainwhat could possibly go wrong with this combination of medications (hint: what are thepossible drug-drug interactions with these two medications).The Calcium channel antagonists interfere with cellular calcium uptake. Calcium increases theblood pressure as calcium causes the heart muscles and blood vessels to contract. The calciumchannel antagonists aim to lower blood pressure by blocking calcium from entering the heartmuscle cells and arteries that leads to relax and a smooth flow of blood (kalra et al., 2010). Acombination of calcium channel blockers such as non- dihydropyridine and Metoprolol couldlead to more atrioventricular block, bradycardia, hypotension and asystole complications(Mylan, 2020). Calcium channel blockers are also slow down the performance rate ofMetoprolol (Saedder et al., 2019).ReferenceBritish Irish Hypertension Society. (2017). Drug Classes., & Jan, A. (2021). Beta Blockers. In StatPearls. Treasure Island (FL): StatPearlsPublishing., S., Kalra, B., & Agrawal, N. (2010). Combination therapy in hypertension: Anupdate. Diabetology & Metabolic Syndrome, 2(1), 44., R. E., (2021). Cardiovascular Physiology Concepts (3rd Edition). Wolters Kluwer., J., & Dunham, A. (2021). Metoprolol. In StatPearls. Treasure Island (FL): StatPearlsPublishing. (2020). Metoprolol IV MYLAN., A., (2019). Diabetes and Beta blockers: what you need to know. healthline., E. A., Thomsen, A. H., Hasselstom, J. B., & Jornil, J. R. (2019). Heart insufficiencyafter combination of verapamil and metoprolol: A fatal case report and literaturereview. Clinical Case Reports, 7(11), 2042-2048., W. D., Sankar, P., & Kariyanna, P. T. (2021). Selective Beta- 1 -Blockers. In StatPearls.Treasure Island (FL): StatPearls Publishing.


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