How fast do you push metopropolol

[Guest219794]

This subject just came up, so I looked it up, and our Mosby guide gives weird instructions

In the "usual dose" section:

MI- 5mg ivp X 3 at two minute intervals. In parenthesis it states that AHA guidelines are q5 not q2. No mention of how fast to push it, just two contradictory sets of instructions on intervals.

A-fib- 2.5-5mg over two minutes, may repeat twice.

unstable angina: 5 mg over 5 minutes.

In the "rate of administration" section:

a single dose over 1 minute

There is mention of iv use for tachycardia or hypertension.

So- I generally push it over 1 minute, unless the bp or hr are borderline. I have been told that when it is ordered 5mg q5min x 3, slow push is not the way to go.

How fast do you push it?

[DManAZRN]

Go with AHA guidelines for the intervals, the push rate of administration you have is 2min small dose, 5min larger dose of 5mg, That is standard for us.

If the hospital P&P even mentions it, go with your hospital guidelines always, so they can never say you "deviated" from policy.

[ACRN06]

1mg/min is an easy rule of thumb to go by

[mmutk, BSN, RN, EMT-I]

I dilute it and push it as fast as I think the patient can tolerate it.

[JessicaSN]

I dilute it and push it as fast as I think the patient can tolerate it.

Isn't this kind of risky? If this is your first time pushing it on a patient, how do you know how they'll tolerate it?

I pretty much push everything slow.

[rjflyn, ASN, RN]

5mg over a min is pretty much slow push for this med. Any slower and your giving the next dose on top of the previous. The typical order is 5mg Q 5mins hold for HR less than 60 or systolic BP less than 100. On some little old ladies I might see it dropped to 2.5mg Q 5mins or as a single dose.

RJ

[I_LOVE_TRAUMA, RN]

5mg/1 min is our policy, generally tol well for each condition

[LinzyRN]

We can only push it if they are on Tele, and we push it over 5min.

[Guest219794]

pretty wide range of practice. some give the drug 5 times faster than others. ocviously, any trained nurse will account for individual patient, but generally speaking, there is still a 500% range in administration rates.

an anybody cite evidence that this drug should go slow. (i mean in general, not on the lol who's v's were near the cut off point etc...)

i just checked davis:

[color=#990000]

iv adminstration:

• direct iv:

diluent: administer undiluted.

concentration: 1 mg/ml

• rate:

administer over 1 min

i am pretty sure the hospital i am in right now doesn't have written guidelines, just an expectaion that nurses are in accordance with drug guides.

[Virgo_RN, BSN, RN]

My IV Med guide by Gahart states to push a single dose of metoprolol over one minute. This is the standard I follow.

[pererau]

My Davis and my Gahart both say 1 minute, and I've never had a problem with that speed. Has anybody else?

[PostOpPrincess, BSN, RN]

Not fast if you have to give it and don't remember the time.