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- Pharmacology For Amlodipine + Metoprolol
Amlodipine + Metoprolol Pharmacology
Amlodipine + MetoprololAbout Amlodipine + MetoprololN/AMechanism of Action of Amlodipine + MetoprololN/APharmacokinets of Amlodipine + MetoprololN/AOnset of Action for Amlodipine + MetoprololN/ADuration of Action for Amlodipine + MetoprololN/AHalf Life of Amlodipine + MetoprololN/ASide Effects of Amlodipine + MetoprololN/AContra-indications of Amlodipine + MetoprololN/ASpecial Precautions while taking Amlodipine + MetoprololN/APregnancy Related InformationContraindicated; since Amlodipine and Metoprolol are contraindicated in pregnancy.So the combination generic cannot be used in pregnancy.Old Age Related InformationN/ABreast Feeding Related InformationContraindicated; since Amlodipine is contraindicated in lactation.Children Related InformationN/AIndications for Amlodipine + MetoprololIt is a combination of calcium channel blocker Amlodipine and Beta blocker Metoprolol.
Interactions for Amlodipine + MetoprololN/ATypical Dosage for Amlodipine + MetoprololAdult: 1 tablet / daySchedule of Amlodipine + MetoprololN/AStorage Requirements for Amlodipine + MetoprololN/AEffects of Missed Dosage of Amlodipine + MetoprololN/AEffects of Overdose of Amlodipine + MetoprololN/A
AmlodipineAbout AmlodipineCalcium Channel Blocker, Anti hypertensive,anti angina.Mechanism of Action of AmlodipineAmlodipine is a second generation dihydropyridine Ca channel blocker. It exerts it`s antihypertensive, antianginal actions through blocking the influx of Ca ions through voltage gated L-type Ca channels to the peripheral vascular smooth muscle cells, Coronary smooth muscle cells and to the myocardial cells. Thus causes dilatation of vascular endothelium, decrease peripheral resistance, & reduce myocardial oxygen demand .It markedly relax arterioles and milder effects on veins. They do not compromise haemodynamics and cerebral and renal perfusion.Pharmacokinets of AmlodipineAbsorption: Well absorbed orally, Distribution: Widely distributed in a protein bound form, Metabolism: Metabolized in liver, but there is no active metabolite.Onset of Action for AmlodipineSlowDuration of Action for Amlodipine24 hoursHalf Life of AmlodipineN/ASide Effects of Amlodipine1.Palpitation
12.Aggravates myocardial ischaemia
Contra-indications of Amlodipine1.Heart failure
3.Hypersensitivity to the drug
6.Along with other anti hypertensive drugs.
Special Precautions while taking Amlodipine1.Cardiovascular disorders: Use cautiously in cardiovascular disorders because it aggravates myocardial ischaemia.
2.Sick sinus syndrome
4.Use cautiously along with other antihypertensive drugs,
Pregnancy Related InformationContraindicated.Old Age Related InformationUse with cautionBreast Feeding Related InformationUse with caution.Children Related InformationContraindicatedIndications for Amlodipine1.Hypertension
3.Stable anginaInteractions for AmlodipineACE inhibitors, Thiazide diuretics: Potentiates effect of these drugs.
Beta Blockers: Best avoided, especially by those with impaired LV function due to depressant effect on myocardial contractibility or AV conduction.
Fentanyl: Severe hypotension or increased fluid volume requirements.Typical Dosage for Amlodipine5 mg once daily.
Maximum dose: 10mg/day
Prinzmetal`s angina and Stable angina:
5 to 10mg once daily.
Hypertension: 2.5 to 5mg once daily. Dose may increase up to 10mg once daily as required by the individual needs.
.Schedule of AmlodipineHStorage Requirements for AmlodipineStore at room temperature below 30 degree C. Protect from moisture and light.
Effects of Missed Dosage of AmlodipineTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of AmlodipineMonitor &support cardiac and respiratory functions. Measure the BP. Give cardiovascular support by elevating the limbs and maintaining fluid balance. Administer vasopressers like nor epinephrine and Calcium gluconate if required.
MetoprololAbout MetoprololA selective ?1 blocker, Anti-hypertensive.Mechanism of Action of MetoprololMetoprolol is a cardio selective beta-1 adrenergic antagonist.
It have negative chronotropic and negative inotropic effects on heart. It decreases oxygen consumption; cardiac work and aortic pressure It decreases nor adrenaline and renin releases. It decreases central sympathetic out flow. In sympathetic over activity, it prolongs systole by retarding conduction. It increases oxygen supply and exercise tolerance in angina patients. The drug decreases BP in hypertensive individuals.
Antimigraine action: Metoprolol is useful in migraine due to its beta blockade action. Through beta blockade action it inhibits vasodilation and relieves migraine.
Pharmacokinets of MetoprololAbsorption: well absorbed orally, bioavailabity is increased by administering along with food. Distribution: Widely distributed. Metabolism: Metabolized in liver by hydroxylation. Excretion: Excreted through urine.Onset of Action for Metoprolol15minutesDuration of Action for MetoprololUp to 1 to12 hoursHalf Life of MetoprololN/ASide Effects of Metoprolol1.Heart failure
Contra-indications of Metoprolol1.Hypersensitivity to the drug
2.Second or third degree heart block
3.Congestive heart failure
Special Precautions while taking Metoprolol1.Congestive heart failure
3.The drug should be gradually withdraw with caution
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicated.Children Related InformationContraindicatedIndications for Metoprolol1.Hypertension
5.Prophylaxis of myocardial infarction
Interactions for MetoprololThioamines: Increased efficacy of metoprolol.
Thyroid hormones: Decreased efficacy of metoprolol.
Benzodiazepines: Increased efficacy of benzodiazepines.
Clonidine: Abrupt withdrawal of clonidine may lead to hypertensive crisis.
Ergot alkaloids: Peripheral ischaemia, possible peripheral gangrene.
Lidocaine: Increased lidocaine level may occur leading to toxicity.
Prazosin: Increased postural hypotension produced by parzosin.
Sulphonylureas: Hypoglycaemic effects may be attenuated.Typical Dosage for MetoprololOral
Adult: 50 to 450mg/day
Hypertension: Starts with 50mg to 100mg/day once daily or in divided doses and gradually increases up to 450mg/day based on patient`s response
Oral: 100mg to 150mg/day in 2 to 3 divided doses
I.V.: Dose range: 10 to 15mg. Starts with 5mg infused within 5minutes. Then repeat the therapy with the same dose at every 5minutes interval based on patient`s response
Maximum dose: 20mg
Angina: 50mg twice daily, gradually increases based on patient`s response at one week intervals
Maximum dose: 0.4gm/day
Migraine: 0.1 to 0.2gm/day in divided doses in 12th hourly to 6th hourly.
Prophylaxis of myocardial infarction: 0.1 to 0.2gm/day in divided doses
Myocardial infarction: 15mg in 3divided doses at 2minutes interval as I.V.bolus administration. Then 200mg orally in four divided doses for 2days.
Schedule of MetoprololHStorage Requirements for MetoprololStore at controlled room temperature between 20 to 25 degree C in a well closed container
Effects of Missed Dosage of MetoprololTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of MetoprololTreatment is supportive and symptomatic. After ingestion empty the stomach by induced emesis or gastric lavage. Administer activated charcoal. Treat Bradycardia with atropine 0.5 to 1mg.If required administer isoproterinol with caution. Treat hypotension with glucagons and vasopressors like epinephrine. Treat cardiac failure with diuretics and cardiac glycosides. Treat bronchospasm with isoproterinol and aminophylline
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