Metoprolol + Telmisartan Pharmacology

Metoprolol + Telmisartan

About Metoprolol + Telmisartan
N/A
Mechanism of Action of Metoprolol + Telmisartan
N/A
Pharmacokinets of Metoprolol + Telmisartan
N/A
Onset of Action for Metoprolol + Telmisartan
N/A
Duration of Action for Metoprolol + Telmisartan
N/A
Half Life of Metoprolol + Telmisartan
N/A
Side Effects of Metoprolol + Telmisartan
N/A
Contra-indications of Metoprolol + Telmisartan
N/A
Special Precautions while taking Metoprolol + Telmisartan
N/A
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Contraindicated
Indications for Metoprolol + Telmisartan
Hypertension
Interactions for Metoprolol + Telmisartan
N/A
Typical Dosage for Metoprolol + Telmisartan
N/A
Schedule of Metoprolol + Telmisartan
N/A
Storage Requirements for Metoprolol + Telmisartan
N/A
Effects of Missed Dosage of Metoprolol + Telmisartan
N/A
Effects of Overdose of Metoprolol + Telmisartan
N/A

Metoprolol

About Metoprolol
A selective ?1 blocker, Anti-hypertensive.
Mechanism of Action of Metoprolol
Metoprolol 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 Metoprolol
Absorption: 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 Metoprolol
15minutes
Duration of Action for Metoprolol
Up to 1 to12 hours
Half Life of Metoprolol
N/A
Side Effects of Metoprolol
1.Heart failure
2.Nightmares
3.Gastrointestinal problems
4.Nausea
5.Tiredness
6.Sinus bradycardia
7.Depression
8.Rash
9.Hypotension
10.Dizziness
11.Fatigue
12.Vomiting
13.Diarrhoea
14.Headache
15.Bronchospasm
Contra-indications of Metoprolol
1.Hypersensitivity to the drug
2.Second or third degree heart block
3.Congestive heart failure
4.Cardiogenic shock
5.Bradycardia
6.Bronchial asthma
7.Diabetes mellitus
Special Precautions while taking Metoprolol
1.Congestive heart failure
2.Hepatic impairment
3.The drug should be gradually withdraw with caution
4.Respiratory disorders
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated.
Children Related Information
Contraindicated
Indications for Metoprolol
1.Hypertension
2.Arrhythmias
3.Angina
4.Migraine
5.Prophylaxis of myocardial infarction
6.Thyrotoxicosis
Interactions for Metoprolol
Thioamines: 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 Metoprolol
Oral
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
Arrhythmias:
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 Metoprolol
H
Storage Requirements for Metoprolol
Store at controlled room temperature between 20 to 25 degree C in a well closed container

Effects of Missed Dosage of Metoprolol
Take 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 Metoprolol
Treatment 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

Telmisartan

About Telmisartan
Angiotensin II Receptor antagonist, Antihypertensive.
Mechanism of Action of Telmisartan
It is a competitive antagonist of angiotensin-2 at AT-1 receptor. It decreases peripheral resistance and lowers BP in hypertensive individuals. It blocks all overt actions of angiotensin-2 such as: - 1. Vasoconstriction, 2. Central & Peripheral sympathetic stimulus, 3. Release of aldosterone and adrenaline, 4. Salt and water reabsorption, 5. Central actions like thirst, vasopressin release, and growth promoting actions on heart and blood vessels.
Pharmacokinets of Telmisartan
Absorption: Absorbed orally, bioavailability is about 42% Distribution: It is distributed in to the body in a highly protein bound form, Metabolism: Metabolized by glucuronide conjugation in to an inactive metabolite. Excretion: Excreted mainly through faeces and rest is excreted through urine.
Onset of Action for Telmisartan
N/A
Duration of Action for Telmisartan
24 hours
Half Life of Telmisartan
24 hours
Side Effects of Telmisartan
1.Dizziness
2.Headache
3.Coughing
4.Edema
5.Nausea
6.Abdominal pain
7.Diarrhoea
8.Dyspepsia
9.Pharyngitis
10.Sinusitis
11.Upper respiratory tract infections
12.Urinary tract infections
13.Elevated liver enzymes
14.Weakness
15.Chest pain
16.Myalgia
17.Back pain
18.Neutropenia
19.Fetopathic
20.Precipitate renal failure in renal artery stenosis, and in insufficient renal blood flow
21.Urticaria
22.Rashes
23.Hyperkalemia

Contra-indications of Telmisartan
Hypersensitivity to the drug
Special Precautions while taking Telmisartan
1.Renal impairment
2.Hepatic impairment
3.Heart failure
4.Aortic or mitral valve stenosis
5.Obstructive cardiomyopathy
6.Use cautiously in volume depleted and salt depleted individuals, these conditions should be corrected before starting the therapy
7.Patient should be cautiously involve in driving or operating heavy machinery during therapy
8.Avoid alcohol or use with caution during therapy
9.Use with caution in hyperkalemia and along with potassium sparing diuretics

Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Contraindicated
Indications for Telmisartan
1.Hypertension
Interactions for Telmisartan
N/A
Typical Dosage for Telmisartan
40mg once daily
Maintenance dose: 20 to 80mg once daily

Schedule of Telmisartan
H
Storage Requirements for Telmisartan
Store at room temperature at a range of 15 to 30 degree C. protects from direct heat and light and store in a tightly closed container. Do not remove blisters until just before taking tablets


Effects of Missed Dosage of Telmisartan
Take the missed dose as soon as remember; if it is the time of next dose then skip the missed dose and take the regular dose
Effects of Overdose of Telmisartan
Treatment is supportive and symptomatic. If hypotension occur kept patient in supine position and if required give I.V. infusion of normal saline

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