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Lopressor (Metoprolol)
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Lopressor

Lopressor is a high-quality medication which is taken in treatment of high blood pressure. It also can be used in the treatment of chest pain, heart attacks.

Other names for this medication:

Similar Products:
Toprol XL

 

Also known as:  Metoprolol.

Description

Lopressor is a perfect remedy. Its target is to struggle against high blood pressure. It also can be used in the treatment of chest pain, heart attacks.

Lopressor acts by slowing the heart rate and relaxing the blood vessels. It is beta blocker.

Lopressor is also known as Toprol-XL, Metoprolol, Protomet, Lopresor, Lopresar.

Generic name of Lopressor is Metoprolol Tartrate.

Brand names of Lopressor are Toprol-XL, Lopressor.

Dosage

Take Lopressor tablets orally with water.

Take Lopressor once or twice a day at the same time.

Do not crush or chew it.

If you want to achieve most effective results do not stop taking Lopressor suddenly.

Overdose

If you overdose Lopressor and you don't feel good you should visit your doctor or health care provider immediately. Symptoms of Lopressor overdosage: fainting, difficulty, breathing or swallowing, swelling of the hands, feet, ankles, or lower legs, lightheadedness.

Storage

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) away from moisture and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Lopressor are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Do not take Lopressor if you are allergic to Lopressor components.

Do not take Lopressor if you're pregnant or you plan to have a baby, or you are a nursing mother.

Be careful with Lopressor if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement.

Be careful with Lopressor in case of taking cimetidine (Tagamet), clonidine (Catapres), diphenhydramine (Benadryl), fluoxetine (Prozac, Sarafem), hydroxychloroquine, paroxetine (Paxil), propafenone (Rythmol), quinidine (Quinaglute, Quinidex), ranitidine (Zantac), reserpine (Serpalan, Serpasil, Serpatab), ritonavir (Norvir), terbinafine (Lamisil),and thioridazine (Mellaril), bupropion (Wellbutrin).

Be careful with Lopressor if you have allergies to medicines, foods, or other substances.

Be careful with Lopressor if you suffer from or have a history of heart or liver disease; diabetes; severe allergies; or an overactive thyroid gland (hyperthyroidism), slow heart rate, heart failure, problems with blood circulation, or pheochromocytoma (a tumor that develops on a gland near the kidneys and may cause high blood pressure and fast heartbeat), had asthma or other lung disease.

Use Lopressor with great care in case you want to undergo an operation (dental or any other).

Avoid alcohol.

Avoid machine driving.

Do not stop taking Lopressor suddenly.

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The hemodynamic effects of dobutamine (5 to 20 microg/kg/min intravenously) and enoximone (0.5 to 2 mg/kg intravenously) were assessed by pulmonary artery catheterization in 29 patients with chronic HF before and after 9 to 12 months of treatment with metoprolol or carvedilol at standard target maintenance oral doses. Hemodynamic studies were performed after >/=12 h of wash-out from all cardiovascular medications, except the beta-blockers that were administered 3 h before the second study.

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beta-Blockers, particularly propranolol, have been shown to be an effective treatment for neuroleptic-induced akathisia (NIA). To examine the relative contribution of beta-1 and beta-2 receptor blockade to the therapeutic effect of propranolol, we studied a beta-1 selective agent (low dose metoprolol) and a beta-2 specific blocker (ICI 118,551). Both agents ameliorated NIA. To further evaluate instruments for quantifying NIA we compared (a) two sets of clinical ratings during the metoprolol study and (b) clinical and electromechanical ratings of NIA during the ICI 118,551 study. The changes in clinical ratings of NIA after metoprolol were similar for most patients; however, the changes in electromechanical and clinical ratings after ICI 118,551 were similar in less than half of the patients studied.

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To estimate associations between use of β-blockers, angiotensin-converting enzyme (ACE) inhibitors, or angiotensin receptor blockers (ARBs) and breast cancer recurrence in a large Danish cohort.

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The responder rate (that is reduction of headache days per month more than 50 %) was 7/10 at three months after the injection. On average the number of headache days per month was reduced from 19.2 days to a minimum of 10.1 days. After three to six months the number of headache days increased again in all responders. Slight local side effects such as redness or temporary pain were observed in all patients, but severe side effects such as infections, fever, ptosis or allergic reactions did not occur.

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The Stockholm Metoprolol Trial is a prospective double-blind placebo-controlled postmyocardial infarction study of 301 patients treated with metoprolol, 100 mg b.i.d., or matching placebo for three years. From this study we have retrospectively evaluated the outcome in patients with a history of treatment for hypertension prior to the index infarction. There were 41 such patients in the placebo group and 35 in the metoprolol group. Blood pressures during follow-up were nearly identical in the two groups. During the three years 11 patients died in the placebo group and 7 in the metoprolol group. Corresponding figures for nonfatal events such as reinfarction, coronary artery bypass surgery, cerebrovascular events and lower limb amputation were 12 vs. 1 (p less than 0.005), 3 vs. 0, 4 vs. 0 and 1 vs. 0, respectively. The numbers of patients with fatal and nonfatal events were 24 vs. 8 (p less than 0.01). In a retrospective subgroup analysis the results must always be interpreted with caution. The present results may, however, imply that postinfarction treatment with metoprolol reduces nonfatal atherosclerotic complications, especially nonfatal reinfarctions, in patients with a history of hypertension.

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The polarity of a drug is one of the most important parameters for the elaboration of switching systems. If the polarity of the drug is low or medium, "reversed-phase" chromatography is well adapted. The plasma or urine sample is diluted with water, centrifuged and injected first into a column of medium polarity (C2, CN or diol bonded phases). The compounds of interest are stopped on the top of the column and rinsed with water, then eluted and chromatographed on a C8 or C18 analytical column. A third column of still lower polarity can be added to improve the specificity of the system. In each successive step, the polarities of the mobile phases and columns should be decreased to reconcentrate the sample and reduce the band broadening that occurred in the previous step. Compounds of high polarity show almost no retention on reversed-phase columns, and normal-phase chromatography should be used. Aqueous solutions cannot be injected into polar bonded-phase columns as they lead to excessive band broadening. This problem can be solved by diluting plasma or urine with a large volume of a water-miscible organic solvent and injecting the clear supernatant. The compounds to be assayed are first reconcentrated on a polar column (NH2 or N(CH3)2 bonded phase) and then eluted. The selected "heart cut" of the eluate is chromatographed on another, more polar column. The influence of the polarity of drugs on the choice of switching systems is exemplified by assay methods for drugs of low, medium and high polarity.

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The aim of this work was to evaluate binding capacity of quinidine, disopyramide and metoprolol to melanin in vitro. The antiarrhythmics studied cause adverse reactions to the eye. Synthetic DOPA-melanin was used in the studies and a UV spectrophotometric method was employed to determine the drugs. The studies of the kinetics of the formation of quinidine-melanin, disopyramide-melanin and metoprolol-melanin complexes indicate that for all the complexes investigated the maximum time to reach reaction equilibrium is 24 h. Binding parameters, i.e., the numbers of independent binding sites and the association constants were determined on the basis of the Scatchard plots. An analysis of the binding curves obtained supports our conclusion that both strong (n1) and weak (n2) binding sites are involved in the formation of the complexes investigated. The total numbers of binding sites in synthetic DOPA-melanin complexes with quinidine, disopyramide and metoprolol were 0.525, 0.493 and 0.387 micromol/mg, respectively. The quinidine-melanin complex is characterized by greater stability (K1 = 3.00 x 10(5) M(-1), K2 = 1.75 x 10(3) M(-1)) in comparison with biopolymer complexes with disopyramide (K1 = 1.12 x 10(4) M(-1), K2 = 6.04 x 10(2) M(-1)) and metoprolol (K1 = 1.42 x 10(4) M(-1), K2 = 7.89 x 10(2) M(-1)). The ability of these drugs to form complexes with melanin in vitro may be one of the reasons for their ocular toxicity in vivo, as a result of their accumulation in melanin in the eye.

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CO(thermo) ranged from 2.1 to 8.2 L/min. CO(PET) determined from both LV and RV was linearly related to CO(thermo) with slopes close to 1 (LV, r = 0.98; RV, r = 0.96; both P < 0.001). Interobserver reproducibility was r = 0.98, P < 0.001. The PCWP range was 6-14 mm Hg and the lung-uptake %ID was 2.7-8.5 %ID. When normalized to baseline, lung-uptake %ID was correlated with PCWP (r = 0.56, P = 0.01) and linearly correlated with LV input resistance (PCWP divided by CO(thermo); r = 0.91, P < 0.001). When both lung-uptake %ID and stroke volume were normalized to baseline, a piecewise linear relation was found (r = 0.95, P < 0.001).

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A 58 year old man experienced an attack of squeezing chest pain. A contrast enhanced computed tomographic scan showed acute dissection of the descending aorta. Treatment with metoprolol and nicardipine kept his blood pressure below 130/90 mm Hg while he was supine at rest and after walking. Serial contrast enhanced computed tomographic scans showed opacification of the false lumen (which was not opacified initially) on the 42nd day; moderate regression of the false lumen on the 67th day, and resolution of the false lumen on the 266th day. This is the first in vivo demonstration of spontaneous resolution of aortic dissection detected by serial contrast enhanced computed tomographic scans.

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D,l-sotalol significantly reduces the incidence of recurrences of sustained ventricular tachyarrhythmias in comparison to no antiarrhythmic drug treatment.

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The addition of flecainide in combination with sotalol/metoprolol may be an effective antiarrhythmic strategy for the control of ventricular arrhythmias in patients with ARVC refractory to single-agent therapy and/or catheter ablation.

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The average RHR at baseline and discharge were (71 ± 13) bpm and (63 ± 9) bpm. The proportion of patients reaching the RHR goals when discharged was 35.9% in stage 1 vs 48.3% (P < 0.001) in stage 2. The rate of β-blocker usage was 80.1% vs 81.0% (P = 0.162) in stage 1, 90.3% vs 91.3% (P < 0.001) in stage 2. The average dose of metoprolol succinate sustained-release tablet was (38 ± 18) vs (39 ± 42) mg/d (P < 0.001) in stage 1, (40 ± 23) vs (46 ± 23) mg/d (P < 0.001) in stage 2. The severe adverse events at both stages had no significant differences.

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At 12 months, patients on carvedilol, compared with those continuing on metoprolol, showed a decrease in LV dimensions (end-diastolic volume -8+/-7 vs. +7+/-6 ml/m2, p = 0.053; end-systolic volume -7+/-5 vs. +6+/-4 ml/m2, p = 0.047), an improvement in LV ejection fraction (+7+/-3% vs. -1+/-2%, p = 0.045), a reduction in ventricular ectopic beats (-12+/-9 vs. +62+/-50 n/h, p = 0.05) and couplets (-0.5+/-0.4 vs. +1.5+/-0.6 n/h, p = 0.048), no significant benefit on symptoms and quality of life and a negative effect on peak oxygen consumption (-0.6+/-0.6 vs. +1.3+/-0.5 ml/kg/min, p = 0.03).

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In patients with CHF, physicians should aim to treat the LV dysfunction, not just the CHF symptoms. LV dysfunction is a chronic disease that is usually progressive, even when it seem compensated. The risk of sudden death or progressive CHF is very real. Adding a beta blocker to the treatment regimen while the disease is still compensated or after resolution of an acute exacerbation can stabilize or reverse the LV dysfunction and improve survival. Beta blockade is now a vital part of the standard of care for most patients with LV dysfunction.

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beta-blockers have been shown to benefit patients after myocardial infarction by decreasing mortality, sudden cardiac death, and reinfarction. Although beta-blockers are recommended for all patients with acute coronary syndromes (ACS) without contraindications, a target heart rate (HR) is recommended only for patients with unstable angina/non ST-elevation myocardial infarction. A contemporary series documenting trends in beta-blocker usage and achieved HR and blood pressures (BP) is not available. The study objectives were to monitor trends in HR and BP in relation to beta-blocker use in a contemporary series of patients with ACS.

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Patients are eligible if they have a positive tilt test and 3 syncopal spells preceding the tilt test. They are excluded if they have seizures or other causes of syncope; important heart disease; a contraindication to or need for beta blockers; a permanent pacemaker; a major noncardiovascular disease; or previous use of beta blockers at a dose greater than the equivalent of metoprolol 25mg twice daily for the purpose of suppressing vasovagal syncope.

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Verapamil sustained-release (SR)/trandolapril is a combination of a phenylalkylamine calcium antagonist and an angiotensin converting enzyme inhibitor for the management of essential hypertension. Verapamil SR/trandolapril does not adversely influence glucose, insulin or lipid parameters in patients with mild to moderate essential hypertension and type 2 (non-insulin-dependent) diabetes mellitus with or without elevated cholesterol and/or triglyceride levels. Verapamil SR/trandolapril reduces proteinuria to a greater extent than the individual components in patients with diabetic or non-diabetic proteinuria. The antihypertensive efficacy of once daily verapamil SR/trandolapril (180/1 or 180/2 mg) for 8 weeks or 6 months is similar to that of atenolol/chlorthalidone (100/25 mg) and lisinopril/hydrochlorothiazide (20/12.5 mg), and was at least as good as that of metoprolol/hydrochlorothiazide (100/12.5 mg) in a small trial. The reduction in sitting or supine diastolic and systolic blood pressure is greater after verapamil SR/trandolapril (180/2 to 240/4 mg) than after monotherapy with verapamil SR (180 and 240 mg/day) or trandolapril (2 to 8 mg/day). Fewer cardiac events occurred after verapamil SR/trandolapril (240/1 to 360/2 mg/day) than after trandolapril (1 to 2 mg/day) in postmyocardial infarction patients with congestive heart failure. The incidence of adverse events after verapamil SR/trandolapril is similar to that of comparator drugs and the individual components of the combination.

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A total of 49,673 patients receiving metoprolol were identified within a cohort of 3,649,285 insurance members. While the crude analysis revealed a higher risk for index events in patients receiving the generic drug (Bremen: RR 1.45; Northern Germany: RR 1.14), no elevated risk remained after confounder adjustment (Bremen: OR 1.06; Northern Germany: OR 1.04). Among co-morbid conditions considered as confounders, a previous CV event and an elevated thromboembolic risk exerted the strongest effect on index events.

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In a study of 48 patients with coronary artery disease and evidence of ischemia during exercise and daily life, metoprolol reduced the threshold of myocardial ischemia in a dose-dependent manner. This effect of beta blockers is probably due to increased coronary tone.

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In this first-in-man study, ten NYHA class III/IV patients were implanted with an ultrasonic pressure-monitoring device, followed a month later by loading with MXL 25 mg/day and uptitrated every two weeks to 200 mg/day. PAP was measured at each follow up. Diurnal variation was evaluated at baseline (no MXL), 100, and 200 mg/day MXL. Treadmill Test (TMT) was performed before and at each uptitration. Echocardiography was performed at one year.

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Since 1990, 1322 patients with syncope of unknown origin have undergone tilt-table testing. Of those, 330 patients (24 X 9%) presented an abnormal response (syncope or pre-syncope). Furthermore, 58 of those patients (17 X 5%) suffered a period of asystole (> or = 3000 ms) during the test. Asystole (median (interquartile range)) lasted 10 (4, 19 X 2) s (range 3-90). Two different protocols (angles) of tilting (Westminster (60 degrees) n=1124; isoproterenol (80 degrees) n=198)) influenced the time to the syncopal episode (13 (6 X 5, 20 X 5) vs 2 (1, 6 X 5) min, P=0,0005) but not the duration of the asystole. During this period, therapy for asystole featured three different stages: first patients were treated with pacemakers; later drug therapy (metoprolol and/or etilefrine) was recommended; lastly (from 1995), no specific treatment was given. In a cohort age- and gender-matched study, those patients without were compared to those with asystole in a 2:1 basis. During 40 X 7 months of follow-up (17 X 7, 66 X 8), 12 patients (20 X 6%) with asystole had syncopal recurrences. Furthermore, 34 patients (28 X 8%) without asystole presented syncopal episodes during a follow-up of 51 X 6 months (29 X 3, 73 X 1) (P=ns). The Kaplan-Meier analysis in patients with and without asystole showed a mean time free of recurrence of 92 X 6 +/- 6 months vs 82 X 6 +/- 4 X 7 months (P=ns). The previous number of syncopes had a significant relationship with recurrences (P=0 X 002), but not therapy. There were no cardiac related deaths.

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Twenty-four heart failure patients were randomised to metoprolol or placebo for 6 months, followed by 6 months of open treatment with metoprolol. Rest and dobutamine stress echocardiography (DSE) was performed before and after each treatment period.

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The β1-adrenergic receptor gene (Entrez Gene:ADRB1), as the target of beta-blockers for hypertension, can directly influence the antihypertensive effect of metoprolol in the Chinese population. This therapeutic effect is often hindered by a lack of evidence-based medical information. To address this challenge, we report a novel assay based on graphene oxide and a CeO2 nanocomposite functionalized by 3-aminopropyltriethoxysilane supported Pt nanoparticles (GO/CeO2/PtNPs) as a signal probe. Due to the large specific surface area and good adsorption properties of the GO/CeO2 nanocomposite, large amounts of PtNPs were immobilized, which amplified the electrochemical signal and improved the sensitivity of the biosensor. To further improvement the sensitivity of the biosensor, Streptavidin (SA) was introduced because it can provide more active sites for the immobilization of the biotinylated capture probe (bio-CP). The electrochemical signal was primarily derived from the catalysis of H2O2 by GO/CeO2/PtNPs. Chronoamperometry was applied to record electrochemical signals, which linearly increased with target DNA. Under optimal conditions, the prepared biosensor had a wide linear range from 1fM to 10nM and a low detection limit of 0.33fM in the detecting of ADRB1 gene. Moreover, the proposed method had good stability and recovery, suggesting its potential for use in clinical research.

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We found that adrenaline increases COX-1 levels in the gastric tissue of both intact and adrenalectomized rats by stimulating alpha-2 receptors. Adrenaline decreases COX-2 levels by stimulating beta-2 adrenergic receptors. Prednisolone inhibits both COX-1 and COX-2 in the gastric tissue of intact rats. In adrenalectomized rats, prednisolone increases gastric COX-1 by stimulating alpha-2 receptors, and decreases COX-2 levels by stimulating beta-2 receptors.

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Criteria for inclusion of patients were: migraine without aura or with short aura for at least 2 years, and 2-10 attacks per month. In all, 63 patients (11 men and 52 women) were each randomized for participation one of the three kinds of treatment. All patients declared their willingness to participate in all three different therapies. After neurological and psychological diagnosis the baseline phase of 2 months was started, followed by the intensive therapy phase lasting 3 months. The end of the intensive therapy is followed by a first 2-month follow-up period. A second follow-up of 2 months was started 6 months after the end of intensive therapy. Psychological diagnosis involved the following elements: a migraine questionnaire, a list of patient's complaints, a depression scale and a psychological exploration. All patients kept a diary during all phases of the study with daily descriptions of their headaches, the therapy and their mood. The psychological programme lasted for 12 sessions of 2 hours each. A psychologist worked with small groups of up to 5 patients This programme was composed of progressive relaxation techniques (Jacobson) and techniques aimed at overcoming pain and stress. The data on diagnosis, the baseline phase, the intensive therapy phase and the two follow-up phases were analysed by conventional statistics (comparison of mean values,t-test, variance analysis, non-parametric tests) and by time series analysis. The parameters analysed were: frequency of attacks, mean headache intensity, duration of headache and migraine, consumption of analgesic drugs and mood. Analysis of the questionnaires and the different diagnostic data revealed no significant differences between the three different groups of therapy.

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The aim of the present work was to evaluate drug release and quality of EVA/drug matrices at different PEO 7M concentrations (5 and 15%), manufactured using two different hot-melt extruders: a lab-scale mini extruder and a pilot-scale extruder. The process parameters used on both extruders (temperature and screw speed) and drug release from the matrices were compared. On the lab-scale extruder all formulations were extruded at 90 °C, whereas on the pilot-scale extruder the temperature of the die was adjusted to 100 °C in order to achieve a constant pressure at the extrusion die, hence constant material flow through the die to yield smooth extrudates. Screw speed was also adjusted from 60 rpm (lab-scale extruder) to 90 rpm (pilot-scale extruder) in order to obtain a balance between feeding rate and screw speed. Drug release from the obtained matrices on both extruders was also assessed. Despite the differences in diameter (diameter of 2 and 3mm for the lab-scale extruder and pilot-scale extruder, respectively), temperature and screw speed, drug release per surface area was similar. DSC analysis of a formulation [EVA40/MPT (50/50, w/w) with 5% PEO] indicated small changes in its solid state after extrusion on both extruders: drug crystallinity was reduced by max. 20%, PEO recrystallized after cooling and EVA remained semi-crystalline. Extrusion experiments on the pilot-scale extruder of EVA/MPT, 50/50 (w/w) formulations were also monitored in-line using Raman and NIR spectroscopy in order to evaluate the material behavior at a molecular level in the extrusion barrel as function of the process settings (extrusion temperature: 90, 110 and 140 °C; screw speed: 90 and 110 rpm). At 90 and 110 °C the crystallinity of the drug was reduced, but the majority of MPT remained in its crystalline state as specific peaks in the Raman spectra of the drug became broader. These differences were accentuated when extrusion was performed at 140 °C as the drug completely melted. Peak shifts to lower frequencies [(CO) groups of the drug and (CH(3)COO) groups of EVA] were registered at all extrusion temperatures, with maximum effect at 140 °C indicating molecular interactions. Increasing the screw speed did not result in peak shifts of Raman spectra. NIR confirmed these observations and showed an additional peak in the spectra characteristic of (OH) bounds.

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Mean molar phenotypic ratios obtained after administering metoprolol (mean change of -11%) or tolbutamide (mean change of -0.3%) alone, were not significantly different from those obtained when other drugs were co-administered (P > 0.05). The mean within-subject coefficients of variation were 33%, 18%, 22%, 13%, 16%, 13% and 5% for CYP3A4, CYP2D6, CYP2C9, CYP2E1, CYP1A2, N-acetyltransferase 2 and xanthine oxidase metabolic ratios, respectively. No significant interactions (P > 0.5) were observed during the simultaneous administration of various combinations of the five probe drugs.

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Male Sprague-Dawley rats were randomly divided into three groups: the sham-operated group, the MI group without metoprolol, which was fed the vehicle, and the MI+metoprolol group receiving intragastric metoprolol. Each group was further divided randomly into three subgroups, depending on the dosage of epinephrine administered during subsequent CPR applied after the induction of asphyxial cardiac arrest.

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Hypertension induces left-ventricular hypertrophy (LVH) by mechanisms involving oxidative stress and unbalanced cardiac matrix metalloproteinase (MMP) activity. We hypothesized that β1-adrenergic receptor blockers with antioxidant properties (nebivolol) could reverse hypertension-induced LVH more effectively than conventional β1-blockers (metoprolol) when used at doses that exert similar antihypertensive effects. Two-kidney one-clip (2K1C) hypertension was induced in male Wistar rats. Six weeks after surgery, hypertensive and sham rats were treated with nebivolol (10 mg kg(-1)day(-1)) or metoprolol (20 mg kg(-1)day(-1)) for 4 weeks. Systolic blood pressure was monitored weekly by tail-cuff plethysmography. LV structural changes and fibrosis were studied in hematoxylin/eosin- and picrosirius-stained sections, respectively. Cardiac MMP levels and activity were determined by in situ zymography, gel zymography, and immunofluorescence. Dihydroethidium and lucigenin-derived chemiluminescence assays were used to assess cardiac reactive oxygen species (ROS) production. Nitrotyrosine levels were determined in LV samples by immunohistochemistry and green fluorescence and were evaluated using the ImageJ software. Cardiac protein kinase B/Akt (AKT) phosphorylation state was assessed by Western blot. Both β-blockers exerted similar antihypertensive effects and attenuated hypertension-induced cardiac remodeling. Both drugs reduced myocyte hypertrophy and collagen deposition in 2K1C rats. These effects were associated with lower cardiac ROS and nitrotyrosine levels and attenuation of hypertension-induced increases in cardiac MMP-2 levels and in situ gelatinolytic activity after treatment with both β-blockers. Whereas hypertension increased AKT phosphorylation, no effects were found with β-blockers. In conclusion, we found evidence that two β1-blockers with different properties attenuate hypertension-induced LV hypertrophy and cardiac collagen deposition in association with significant cardiac antioxidant effects and MMP-2 downregulation, thus suggesting a critical role for β1-adrenergic receptors in mediating those effects. Nebivolol is not superior to metoprolol, at least with respect to their capacity to reverse hypertension-induced LVH.

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lopressor overdose treatment 2015-08-19

An increasing attention is paid to the potential harmful effects of aquatic contaminant pharmaceuticals exerted on both biosystems and humans. In the present work the effects of 14 pharmaceuticals including NSAIDs, antibiotics, β-blockers and a frequently used X-ray contrast media on the proliferation and migratory behavior of the freshwater ciliate Tetrahymena pyriformis was investigated. Moreover, the mixture toxicity of four selected pharmaceuticals (diclofenac, ibuprofen, metoprolol buy lopressor and propranolol) was evaluated in binary mixtures using full factorial experimental design. Our results showed that the sensitivity of Tetrahymena to NSAIDs and β-blockers (EC(50) ranged from 4.8 mg L(-1) to 308.1 mg L(-1)) was comparable to that of algal or Daphnia bioassays. Based on these elevated EC(50) values acute toxic effects of these pharmaceuticals to T. pyriformis are unlikely. Antibiotics and the contrast agent sodium-diatrizoate had no proliferation inhibiting effect. Chemotactic response of Tetrahymena was more sensible than proliferation as significant chemorepellent action was observed in the environmentally realistic concentration range for acetylsalicylic acid, diclofenac, fenoprofen, paracetamol, metoprolol, propranolol, timolol and trimethoprim (Chemotaxis Index ranged from 63% to 88%). Mixture toxicity experiments resulted in a complex, concentration dependent interaction type pattern with antagonism being the predominant interaction type (59%) followed by additivity (37%) and synergism (4%). Hence the concept of concentration addition validated for NSAIDs in other organisms cannot be adopted for this ciliate. In summary authors suggest Tetrahymena as a sensible model of testing aquatic contaminants as well as underline the significance using more specific endpoints to understand the complex mechanisms investigated.

lopressor dosing iv 2017-09-05

Electrophysiological studies with prenalterol in 19 patients (6 women, 13 men, 5 with sinus node disease, 4 with AV node disease, 7 with double node disease, 2 with conduction disturbance below His bundle, 1 normal) showed that sinus node function (heart rate, sinus node recovery time) is uniformly improved by this beta-stimulator. Also AV conduction is significantly and uniformly improved (shortening of AH interval and of the functional refractory period of AV conduction). There is no buy lopressor or little influence on intra-atrial conduction and on conduction below the His bundle. However, spontaneous depolarisation in His-Purkinje fibers--as tested in patients with complete AV block and ventricular demand pacemaker--is increased through beta-stimulation with prenalterol as reflected by shorter escape intervals and higher frequency escape rhythm. Prenalterol may be of clinical use in patients with cardiomyopathies who developed bradycardia under digitalisation or patients with severe bradyarrhythmia either with or without digitalis. It might also be useful in rare emergency situations, when complete pacemaker failure develops.

lopressor dose conversion 2016-03-19

There are few buy lopressor case reports and little experience when dabigatran is taken in overdose. This is a case report of a large dabigatran overdose presenting data on the extraction ratio and clearance of dabigatran using continuous veno-venous hemodiafiltration.

lopressor 50mg tablets 2017-03-11

Based on the hypothesis that pulmonary vein isolation could result in the damage of the epicardial fat pads, this study aimed to investigated the impact of right upper pulmonary vein (RUPV) isolation on vagal innervation to atria. buy lopressor

lopressor medicine 2017-06-21

Celiprolol is a cardioselective beta-adrenoceptor antagonist with attributed cardiostimulant properties. Its hemodynamic profile was compared in a dose-response study with that of metoprolol, which is also cardioselective but lacks cardiostimulatory activity. In 24 patients with angiographically proved coronary artery disease, simultaneous hemodynamic and left ventricular ejection fraction (EF) values were determined at rest in the control (drug-free) state and repeated 3 to 5 minutes after each of four intravenous boluses of celiprolol, 1, 1, 2, and 4 mg, or equivalent beta-blocking doses of metoprolol, 1.25, 1.25, 2.5, and 5.0 mg. The effects of buy lopressor each drug on hemodynamics during exercise-induced angina were determined by exercise testing in the control state and after the maximum cumulative dose of each drug. At rest, metoprolol reduced heart rate, cardiac index, and the left ventricular EF and increased pulmonary artery occluded pressure (PAOP), systemic vascular resistance, and left ventricular end-systolic and end-diastolic volumes. Celiprolol increased cardiac and stroke volume indices and the EF; the PAOP was reduced without change in other measured variables. During exercise, metoprolol significantly increased the PAOP, which was unchanged by celiprolol. At exercise both drugs reduced cardiac index and heart rate, but neither altered the EF. The cardiac function curve demonstrated greater depression at rest after metoprolol than after celiprolol; these differences were attenuated during dynamic exercise. The lesser adverse impact of celiprolol on cardiac function may be attributable to ancillary cardiac stimulatory properties offsetting the cardiac depression after beta-adrenoceptor blockade.

lopressor drug 2017-11-07

We considered randomized trials comparing anxiolytic or antidepressant drugs to buy lopressor placebo or an alternative therapeutic control for smoking cessation. We excluded trials with less than 6 months follow-up.

lopressor name brand 2017-03-11

The effects of ranitidine on the pharmacokinetics of metoprolol were examined in two studies. In the first study, pharmacokinetics of single doses of metoprolol were examined in six subjects before, during and after ranitidine administration for 1 week. Peak concentrations of metoprolol were increased on ranitidine but its half-life and clearance were unaltered. In the second study, 12 subjects received metoprolol twice daily for 1 week; once with ranitidine buy lopressor and once with placebo. Ranitidine had no effects on the chronic-dose pharmacokinetics or pharmacodynamics of metoprolol. The chronic dose study suggests no inhibition of the metabolism of metoprolol by ranitidine. The single dose study suggests, however, that some interaction of an as yet unknown nature, cannot be excluded.

lopressor 20 mg 2015-12-06

We have documented a pre-junctional beta-2 adrenoceptor mediated reduction in buy lopressor cardiac norepinephrine spillover (CNES) in heart failure patients receiving chronic beta-blockade. Our present objective was to ascertain the consequence of this decrease for vagal heart rate (HR) regulation by determining CNES, arterial baroreflex sensitivity for HR (BRS) and arterial baroreflex modulation of muscle sympathetic nerve activity (MSNA) before and upon 4 months of beta-blockade with either carvedilol or metoprolol. In 19 heart failure patients in sinus rhythm (age: 55+/-2 [mean+/-S.E.]; ejection fraction: 20+/-2%), beta-blockade increased BRS from 4.8+/-0.9 to 7.9+/-1.3 ms/mm Hg (P<0.005) but had no effect on arterial baroreflex modulation of MSNA. Changes in CNES and BRS were inversely related (r=-0.52; n=16, P<0.05). Chronic beta-blockade in heart failure augments reflex vagal control of HR at an efferent site of interaction involving blockade of cardiac sympathetic pre-junctional beta-2 adrenoceptors that facilitate NE release.

lopressor 40 mg 2016-01-26

Hemorrhagic shock is associated with increasing catecholamine plasma concentrations. Plasma catecholamines are known to affect cellular immune functions. We therefore, investigated the effect of endogenously released catecholamines on lymphocyte distribution (CD4+ lymphocytes, CD8+ lymphocytes, and natural killer (NK) cells), splenocyte apoptosis (Annexin V binding), tumor necrosis factor-alpha (TNF-alpha), and interleukin 10 (IL-10) release during a volume-controlled hemorrhagic shock in mice. Mice received either saline (HEM), the non-selective beta-adrenoceptor antagonist propranolol (PROP; 2 mg/kg i.p.), or the beta1-adrenoceptor antagonist metoprolol (MET; 2 mg/kg i.p.) before induction of hemorrhage. Mice were sacrificed to obtain the spleen and whole blood 1 h after hemorrhage, 1 h after fluid resuscitation, and 24 h after hemorrhage. Flow cytometric analysis revealed an increase in circulating NK cells in the HEM buy lopressor group. This effect was completely abolished by pretreatment with propranolol or metoprolol. Furthermore, administration of either beta-adrenoceptor antagonist led to a decrease of circulating CD8+ lymphocyte numbers. Monitoring of splenocyte apoptosis by determination of Annexin V binding revealed an increase in splenocyte apoptosis 24 h after hemorrhage in the HEM group but not in the animals pretreated with propranolol or metoprolol. Induction of hemorrhage did not affect TNF-alpha or IL-10 plasma concentrations in either experimental group. We conclude that plasma catecholamines affect cellular immunity in the early phase of trauma via a beta-adrenergic pathway.

lopressor hct cost 2016-06-25

A simple direct injection chromatographic procedure with fluorimetric detection is successfully applied to the determination of mixtures of 4 diuretics (amiloride, bendroflumethiazide, piretanide, and triamterene) and 6 beta-blockers (acebutolol, atenolol, labetalol, metoprolol, nadolol, and propranolol), which are usually administered in combinations for the treatment of hypertension, in urine samples. The procedure makes use of C18 columns and micellar mobile phases of sodium dodecyl sulphate (SDS), propanol, and phosphate buffer at pH 3. The adequate resolution of most drugs is obtained with a chemometrics approach where the retention is modeled as a first step using the retention factors in only 5 mobile phases. Afterward, an optimization criterion that takes into account the position and shape of the chromatographic peaks is applied. A mobile phase of 0.11M SDS--8% propanol could resolve mixtures of 8 drugs and was adequate for the analysis of the combinations of diuretic and beta-blocker usually prescribed. However, a mobile phase of larger elution strength, such as 0.15M SDS--15% propanol, is preferred for the analysis of mixtures of amiloride-metoprolol, amiloride-labetalol, and triameterene-propranolol. The method is sensitive enough for the routine analysis of diuretics and beta-blockers at therapeutic urine levels with limits of detection in the 0.5-28-ng/mL range. Urinary excretion studies show that the detection of most drugs is possible up to 24-72 buy lopressor h after their ingestion.

lopressor 400 mg 2017-03-25

To evaluate the efficacy of oral treatment with nebivolol and metoprolol in the prophylaxis buy lopressor of migraine attacks.

lopressor 25 mg 2015-12-10

The effects of one-month treatment of β-adrenergic receptor (AR) blockers on the relaxant function of airway in chronic obstructive buy lopressor pulmonary disease (COPD) are unknown. A passive cigarette smoking rat model was used to investigate the effect of β-AR blockers.

lopressor starting dose 2016-08-30

Partition coefficients (log D and log P) and molecular surface area (PSA) are potential predictors of the intestinal permeability of drugs. The aim of this investigation was to evaluate and compare Abilify Normal Dose these intestinal permeability indicators.

lopressor generic drug 2016-08-30

We first show two missense KCNQ1 mutations - R380S and W305L - in Chinese long QT syndrome patients, resulting in the loss of protein function. Mutation W305L in the P-loop domain of the Kv7.1 may derive a Nexium 30 Mg pronounced benefit from β-blocker therapy in symptomatic long QT syndrome patients, whereas mutation R380S located in the C-terminus may be associated with a high risk of sudden cardiac death.

lopressor xl dosage 2016-10-08

A high adrenergic strain during reperfusion after ischemia impedes functional recovery. Conversely, adrenergic blockade may be beneficial during reperfusion. This study was undertaken to find out if early postoperative Diamox Generic Name high-dose infusion of the selective beta 1-blocking agent metoprolol tartrate has additional effects on metabolic variables related to myocardial energy supply/demand balance compared with those obtained with a late preoperative oral dose. The study included 21 male patients undergoing coronary bypass grafting. All patients received an oral dose of metoprolol before the operation. After the operation, patients were randomized to a control group or a group receiving intravenous infusion of metoprolol. Myocardial uptake of oxygen and substrates was determined before and during atrial pacing. Metoprolol reduced arterial concentrations of free fatty acids, reduced myocardial uptake of free fatty acids, and enhanced myocardial uptake of lactate. During paced tachycardia, the metoprolol concentration correlated negatively with myocardial uptake of free fatty acids (r = -0.80; p < 0.001) and positively with myocardial uptake of lactate (r = 0.53; p < 0.05). It is concluded that postoperative infusion of metoprolol induces myocardial metabolic changes compatible with an improved energy supply/demand balance.

lopressor missed dose 2017-11-23

Despite optimal therapy, mortality remains significant in high-risk patients following MI. Although there is a trend in favour of EPS-guided/ Prograf Pediatric Dosage ICD, our data are insufficient to demonstrate a survival benefit of this strategy early after MI.

dosage lopressor 2015-07-07

Activation of postsynaptic noradrenergic alpha 1-receptors may be involved in the mediation of psychomotor activating effects of tricyclic antidepressant (TCA) drugs. On the other hand, the pronounced sedative properties of some TCA drugs seem to be correlated with their alpha 1-receptor blocking capacity. The presynaptic alpha 2-receptors probably mediate the feed back inhibition of central NE neurons seen after administration of TCA Uroxatral Drug Interactions drugs, particularly the secondary amines. Yet other antidepressants such as mianserin are potent antagonists at central alpha 2-receptors, a phenomenon which can even cause activation of brain NE neurons and form a basis for their therapeutic action. beta-Receptor activation in the brain is also suggested to participate in the therapeutic effect of several drugs, e.g. mianserin and the putative antidepressant agent salbutamol, a beta 2- receptor agonist. A reduced central beta-receptor activation may, accordingly, contribute to depressive symptoms associated with treatment with beta-adrenoceptor blocking drugs, both by their action per se as well as by secondary effects on the monoamine systems, which we recently have demonstrated. Facilitation of brain 5-HT neurotransmission seems to be achieved with several TCA drugs not only via inhibition of reuptake but also through sensitization of postsynaptic 5-HT receptors, developing during repeated treatment. In contrast the "presynaptic" 5-HT receptors do not show increased sensitivity during chronic TCA drug treatment, thus allowing for an enhanced synaptic effect of 5-HT induced by TCA drugs.

lopressor y alcohol 2015-11-20

ACTH, AVP and cortisol secretion were not stimulated by induced hypotension to MAP of 60 mm Hg before surgery. Increased aldosterone secretion occurred and a further study with Prandin Drug a larger sample size is needed.

lopressor online 2016-09-02

A chiral liquid chromatography-tandem mass spectrometry (HPLC-MS-MS) method was developed and validated for measuring individual enantiomers of three beta-blocker drugs (atenolol, metoprolol, and propranolol) in wastewater treatment plant (WWTP) influents and Levaquin 10 Mg effluents. Mean recoveries of the pharmaceuticals ranged from 67 to 106%, and the limits of detection of the analytes were 2-17 ng/L in wastewater effluents. The method was demonstrated by measuring, for the first time, the stereoisomer composition of target analytes in raw and treated wastewaters of two Canadian WWTPs. In these trials, racemic amounts of the three drugs were observed in influent of one wastewater treatment plant, but nonracemic amounts were observed in another. Effluents of the two plants contained nonracemic amounts of the drugs. These results indicate that biologically-mediated stereoselective processes that differ among WWTPs had occurred to eliminate individual enantiomers of the target analytes.

lopressor max dose 2016-04-13

The plasma concentrations of metoprolol enantiomers have been determined by means of a direct phenyl carbamate-cellulose-based chiral high performance liquid chromatography assay using fluorimetric detection. Zyrtec Drug Interactions This assay has been used to investigate the pharmacokinetics and pharmacodynamics of metoprolol enantiomers in the conscious goat. There is evidence that the pharmacokinetics of metoprolol in the goat occurs stereoselectively and that enantiomer-enantiomer pharmacokinetic interactions occur. R-Metoprolol is less effective in reducing the mean arterial blood pressure than S- and R/S-metoprolol.

lopressor tabs 2017-12-06

Two cases of acute myocarditis Symmetrel Drug Interactions in young men, both with clinical and laboratory criteria indicating poor prognosis, were initially treated with conventional treatment (captopril plus metoprolol). The addition of intravenous immunoglobulin was followed by rapid clinical and laboratory recovery. This observation is considered to support previous but ambiguous evidence that autoimmune treatment may help recovery from acute myocarditis that has evidence of poor prognosis.

lopressor metoprolol medication 2015-03-15

Data from electronic dosing monitors and published pharmacokinetic parameters were used to derive medication adherence measures for immediate-release metoprolol and examine their association with health care utilization of outpatients aged 50 years or older with heart failure.

lopressor medication 2015-02-01

Early metoprolol administration during acute coronary occlusion increases myocardial salvage. The extent of myocardial salvage, measured as the difference between myocardium at risk and myocardial necrosis, was associated with regional and global LV motion improvement.

lopressor safe dose 2015-08-16

We describe a case of drug-induced fever probably associated with clonidine administration. The higher dose of clonidine alone or in interaction with duloxetine and atorvastatin may have contributed to the development of drug-induced fever.