Mr. Qin, a retired old man, was enjoying his old age, but he had been suffering from heart failure. Every day, when he is active, he will feel short of breath, fatigue, and unable to move freely as beforeHe's been on the radar for a while, but he doesn't think it's going to work well.
One day, Mr. Qin met a patient during a follow-up visit, Mr. Li. Mr. Li is also a heart failure patient, but he told Mr. Qin that he had been taking a drug called metoprolol and that it worked very well.
After hearing this, a glimmer of hope rose in Mr. Qin's heart, maybe this medicine could improve his condition.
So,Mr. Qin decided to try this drug. He did not consult a doctor and did not have the necessary testsHe went directly to the pharmacy to explain his heart failure condition, and the doctor prescribed it, so Mr. Qin successfully purchased the drug and started taking it, hoping that the drug would bring him improvement.
Mr. Qin forgot that he also had a history of sinus bradycardia. While taking the medication, his condition worsened, he felt more short of breath, and he was too tired to complete his daily activities, and even had difficulty walking up stairs.
His family sensed something was wrong with him and immediately rushed him to the hospital. The doctor conducted a comprehensive evaluation of Mr. Qin and found hisThe heart rate was very low, shortness of breath, and there was significant edema in the lower limbs, and the results of the electrocardiogram showed that Mr. Qin's heart rate was less than 50 minutes per minute. At the same time,Blood tests also revealed that he also had problems with kidney function (proteinuria +++ serum creatinine 231 mol l, urea nitrogen 8.).5 mmol), electrolyte balance was also affected.
After inquiry, the doctor realized that the root cause of the problem was that Mr. Qin had taken metoprolol by mistake, so he immediately took emergency measures against Mr. Qin. After the condition subsided, the doctor gave Mr. Qin health education, explained the indications and contraindications of metoprolol, emphasized the importance of not changing or stopping the drug on your own**, and should communicate with the doctor in advance if you have any questions about the disease.
After this fright, Mr. Qin also understood the stakes, and said that he would definitely not change things related to ** on his own in the future.
On the big stage of modern medicine, cardiologists play a vital role, and they use their wisdom and technology to save countless patients who suffer from heart diseases. And in their medical "toolbox", there is a drug known as the "miracle drug of cardiology", and that is metoprolol. However, metoprolol is not a suitable drug for all heart patients, so let's take a look at this miracle drug.
Metoprolol, the name is perhaps not unfamiliar to most peopleThese drugs improve heart function and reduce symptoms by blocking receptors in the heart and blood vessels, reducing the heart's workload and blood pressure.
Metoprolol is widely used in the field of cardiology, and it is used for a variety of diseases such as hypertension, angina, and arrhythmia[1].
First of all, it is widely used for high blood pressure.
High blood pressure is a common cardiovascular disease that can lead to serious consequences such as heart disease and stroke if not controlled in time. The drug can effectively control the development of hypertension by blocking heart receptors, slowing down the heart rate and reducing the contractility of the heart, thereby reducing the workload of the heart and blood pressure.
Secondly, it plays an important role in angina**.
Angina pectoris is a condition of chest pain caused by insufficient blood supply to the heart, which can lead to myocardial infarction in severe cases. The drug can effectively reduce the load on the heart, relieve angina symptoms and improve the quality of life of patients by slowing the heart rate and reducing the oxygen consumption of the heart.
In addition, it is suitable for arrhythmias**. Arrhythmias are heartbeat rhythm disorders caused by abnormal electrical signaling in the heart, which can lead to complications such as heart failure in severe cases. Metoprolol effectively controls the onset of arrhythmia by blocking receptors, slowing down the heart rate, adjusting the heart rhythm, and restoring normal electrocardiogram.
Finally, it can also be used for myocardial infarction.
Myocardial infarction is an important complication of coronary heart disease and, in severe cases, may lead to cardiac insufficiency. The drug can reduce myocardial damage caused by myocardial ischemia by inhibiting the activity of the sympathetic nervous system, protect myocardial cells, promote myocardial repair, and reduce cardiac load after myocardial infarction.
To sum up, the drug, as a miracle drug in cardiology, has a wide range of indications, including:High blood pressure, angina, arrhythmias, and myocardial infarctionTarget**. Its unique mechanism of action and good clinical effect make it an important drug in heart disease**. However, for individual patients, it still needs to be used reasonably under the guidance of a doctor to ensure that the efficacy is maximized, the occurrence of *** is minimized, and the misuse of the drug is avoided in patients with contraindications.
Cardiogenic shock. This is a serious acute complication of heart disease, characterized by a marked decrease in the heart's pumping function, resulting in hypoperfusion of tissues and organs. Metoprolol has the effect of slowing the heart rate and reducing the contractility of the heart, which may further reduce cardiac output, exacerbate shock symptoms, accelerate the progression of the disease, and lead to coma, hypotension, and damage to various organs.
degree of atrioventricular block. This is an abnormality in the conduction system of the heart that causes a disturbance in the heart rhythm. Metoprolol has a depressive effect on the conduction system of the heart, may exacerbate the degree of interventricular block, and even lead to life-threatening cardiac arrest, so the drug is contraindicated in patients with a history of such conditions.
Decompensated heart failure. It is a serious heart disease in which the heart is unable to pump blood effectively, resulting in insufficient perfusion of tissues and organs. Metoprolol reduces the heart's workload by slowing the heart rate and reducing the heart's contractility, which may further weaken heart function and worsen heart failure such as shortness of breath, edema, fatigue or cause severe arrhythmias.
Bradycardia or hypotension. Metoprolol has the effect of slowing down the heart rate and lowering blood pressure, and if the patient already has bradycardia or hypotension, the use of metoprolol may only further reduce the heart rate and blood pressure, leading to cardiovascular insufficiency, causing serious complications such as shock, cardiac arrest, and multiple organ dysfunction syndrome.
Severe peripheral vascular disease. In these patients, blood is already restricted** because the blood vessels have been narrowed or occluded. As mentioned above, metoprolol has the effect of lowering blood pressure, so if such people continue to take the drug, it will aggravate the symptoms of limb ischemia, leading to thrombosis, gangrene or necrosis, and in severe cases, amputation.
In summary, metoprolol is an important drug in heart disease**, but its contraindications include but are not limited to the above 5 kinds, so before deciding to take metoprolol, be sure to provide a detailed medical history or do a comprehensive examination to the doctor, and grasp the main precautions of the drug to ensure the safe and effective use of this drug.
First of all, as for the way to take metoprolol, it is often in the form of tablets**, and patients need to swallow the tablets whole or break them along the nicks as needed, and do not chew them. This is because the drug release rate and concentration of the pills are scientifically designed, and chewing the tablets may cause the drug to be released too quickly or excessively; Extended-release tablets usually have a coating to protect the stability of the drug in stomach acid, and chewing the tablets can destroy the coating; Chewing the pills can also lead to inaccurate dosages, affecting the efficacy and safety of the drug.
Secondly, do not change the dosage form without permission. Metoprolol is available in different dosage forms, such as sustained-release tablets, regular tablets, etc., however, the same metoprolol cannot be mixed with different dosage forms. This is because there are differences in the release speed and concentration of drugs in different dosage forms, and the number and time of taking them are also different, for example, ordinary tablets are taken 2-4 times a day on an empty stomach, but sustained-release tablets only need to be taken once a day, and the time of taking them is not affected by meals.
Third, the dose must be gradually reduced when the drug is stopped
This is because abrupt discontinuation of the drug may lead to adverse reactions such as rebound heart rate and increased blood pressure, and even induce critical illness such as myocardial infarction. Therefore, before stopping the drug, it is necessary to discuss with the doctor that the dose should be slowly reduced for no less than 3 days, so as to give the heart time to adapt and reduce the occurrence of adverse reactions [3].
Fourth, monitor your heart rate while taking the medication
Metoprolol mainly works by lowering the heart rate. Therefore, during the course of taking, the heart rate should be monitored regularly, and when the heart rate is lower than 55 beats, stop the drug in time and consult a doctor. The importance of this monitoring is to ensure that the drug regulates the cardiovascular system properly and that any abnormalities are detected and treated in a timely manner.
Fifth, it should be used with caution when driving and performing delicate operations
Metoprolol may cause fatigue and dizziness, among other things***, which can affect our ability to concentrate and react. Therefore, while taking metoprolol, activities that require a high degree of concentration, such as driving a motor vehicle or performing delicate operations, should be carefully considered. This caution is to ensure our own safety as well as the safety of others.
Finally, use with caution during pregnancy and lactation
Metoprolol may cause adverse effects on the fetus, and the effects of the drug may also be passed on to the baby through breast milk. In these cases, unless necessary, follow your doctor's advice and seek other suitable options to ensure the health of the mother and baby.
In short, although the drug has been widely used, this does not mean that it is 100% safe, and we need to pay attention to the relevant information of the drug at the same time as the disease, so as to avoid the occurrence of adverse reactions to the greatest extent.
Mr. Qin did not seek the doctor's consent before taking the medicine, nor did he carefully understand the drug, which almost led to irreversible consequences. Therefore, no matter what the drug is, we must know its indications and contraindications before taking it, and we need to understand its precautions and common adverse reactions during taking it.
As the saying goes: only by knowing oneself and knowing one's opponent can we win all battles, and only by understanding diseases and drugs as much as possible, or strictly following the doctor's instructions, can we safely and effectively use drugs to control diseases and ensure the health and safety of the body.
[1] Huang Jun. Essence of "Expert Consensus on the Use of Receptor Blockers in Cardiovascular Diseases" [J].Chinese Journal of Hypertension, 2011, 19 (02): 109-111 doi:10.164392] Jia Linzhen, Wei Linting. Pharmacological effects of metoprolol and clinical contraindications[J].Primary Medicine Forum, 2016, 20 (12): 1683-1684 doi:10.19435
3] Gao Wenxue, Gao Lei, Yan Meixing. Safety of metoprolol in clinical use[J].Chinese Clinician, 2012, 40 (03): 38-41