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Sample guide · Beta-Blockers

Metoprolol

Brand: Lopressor, Toprol-XL

Beta-blockers block beta-adrenergic receptors in the heart, slowing the heart rate and reducing the force of contraction. Think of them as putting the brakes on an overactive heart. They end in "-olol" — metoprolol, propranolol, atenolol. They lower blood pressure, reduce angina, and improve survival after a heart attack. Key trick: non-selective beta-blockers (like propranolol) also block beta-2 receptors in the lungs, which can cause bronchospasm — so they're risky in asthma/COPD. Cardioselective ones (metoprolol, atenolol) are safer but still used with caution.

Pharmacological ActionCardioselective beta-1 blocker; lowers HR, BP, and cardiac workload

Therapeutic UseHypertension, angina, heart failure, post-MI

ComplicationsBradycardia, fatigue, dizziness, hypotension, erectile dysfunction Severe bradycardia/heart block, acute decompensated heart failure, severe bronchospasm, cardiogenic shock, severe hypotension, hypoglycemia unawareness

Contraindications / PrecautionsSevere bradycardia, heart block, decompensated heart failure, severe asthma

Medication Administration25-100 mg PO BID (IR); 50-200 mg PO daily (XL) Check apical pulse; hold if HR < 60. Cardioselective but still use caution in asthma.

Sample practice questions

1 of 3

When teaching a patient with heart failure who is starting metoprolol, which instruction is most important?

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For educational use only. Not a substitute for professional medical advice, clinical judgment, or your institution's approved drug reference — lab ranges and protocols differ between hospitals, facilities, and programs, so always verify against yours.