Bisoprolol fumarate

dr.joandr.joan عضو ماسي
تم تعديل 2009/05/27 في أدوية الطوارئ Emergency drugs
5. Bisoprolol fumarate:
Trade name: Zebeta
Class: Beta-adrenoceptor blocking drugs
Pregnancy: (Category C)

Action:
§ Blocks adrenergic receptors of the sympathetic nervous system in the heart and juxtaglomerular apparatus (kidney), thus decreasing the excitability of the heart.
§ Decreasing cardiac output and oxygen consumption, decreasing the release of rennin from the kidney, and lowering blood pressure.
Uses:
§ Management of hypertension,
§ used alone or with otherantihypertensive agents
Dose
Hypertension and angina, usually 10 mg once daily (5 mg may be
adequate in some patients); max. 20 mg daily
Adjunct in stable moderate to severe heart failure, initially 1.25 mg once daily (in the morning) for 1 week then, if well tolerated, increased to 2.5 mg once daily for 1 week, then 3.75 mg once daily for 1 week, then 5 mg once daily for 4 weeks, then 7.5 mg once daily for 4 weeks, then 10 mg once daily; max. 10 mg daily
Contraindications:
· Sinus bradycardia, second- or third-degree heartblock, cardiogenic shock, CHF.
· Use cautiously with renal failure, diabetes or thyrotoxicosis (bisoprolol can mask the usual cardiac signs of hypoglycemia and thyrotoxicosis), lactation.
Side effects:
  • CNS: Dizziness, paresthesias, sleep disturbances, hallucinations, disorientation, memory loss, slurred speech .
  • GI: Gastric pain, flatulence, constipation, diarrhea, nausea, vomiting, anorexia, ischemic colitis, , retroperitoneal fibrosis, hepatomegaly, acute pancreatitis.
  • CV: Bradycardia, CHF, cardiac arrhythmias, sinoatrial or AV nodal block, tachycardia, peripheral vascular insufficiency, claudicating, CVA, pulmonary edema, hypotension
  • Respiratory: Bronchospasm, dyspnea, cough, bronchial obstruction, nasal stuffiness, rhinitis, pharyngitis.
  • GU: Impotence, decreased libido, Peyronie's disease, dysuria, nocturia, frequent urination.
  • Musculoskeletal: Joint pain, arthralgia, muscle cramp
  • EENT: Eye irritation, dry eyes, conjunctivitis, blurred vision
  • Other: Decreased exercise tolerance, development of antinuclear antibodies, hyperglycemia or hypoglycemia, elevated serum transaminase, alkaline phosphatase, and LDH
Nursing considerations:
· Do not discontinue drug abruptly after chronic therapy (hypersensitivity to catecholamine may have developed, causing exacerbation of angina, MI, and ventricular arrhythmias).
· Taper drug gradually over 2 wk with monitoring.
· Consult with physician about withdrawing drug if patient is to undergo surgery (withdrawal is controversial).