140 mg lopressor with no effects to me.

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Hi! I'm new to the forum. I'm a CTICU nurse. I had Cardiovascular CT(but cancelled) http://www.theplc.net/arteryscans.shtml today for unspecified chest pain. But they want my heart HR to be around 60 to 65 when they will inject the dye. My HR was 113bpm ST(since highschool my hr is 90's to 103 Sinus). They gave me lopressor 100mg po and after 45 min my heart rate was around 87bpm. Now I was already at the CT scan table they gave me another 10mg IVP lopressor after 5 mins it is still 84bpm. another dose was given still the same hr around 80's. So the total was 40mg ivp and 100mg po for a total of 140mg. My gosh mostly my patient will respond to 2.5 to 5mg ivp. So they cancelled my procedure. They just did a calcium score which is zero. I'm not sure if I have beta receptors LOL. Any ideas why. T.Y

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Specializes in LDRP.

LOL, my poor pt's would have a blood pressure of 0 with all that lopressor.

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Specializes in Emergency & Trauma/Adult ICU.

In the ER all the Lopressor I give is IV ... usually 5mg, possibly a repeat dose of an additional 5 or 10mg. I don't think I've ever given more than a total of 20mg over several hours.

I'm sure p.o. dosing is different, but 40mg IV? Seems like an awful lot to me ...

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that's why when they sent me home i asked my wife to drive. I'm so paranoid that i may just arrest while driving because in some patient it takes time but not with 40mg(total ivp) 5 to 10 mins apart.

LOL, my poor pt's would have a blood pressure of 0 with all that lopressor.
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they say that's the max i can have. when she started giving me 10mg ivp. i started looking for the crash cart. normally i will start 2.5 even the order is 5mg just to see how it will affect the patient.

In the ER all the Lopressor I give is IV ... usually 5mg, possibly a repeat dose of an additional 5 or 10mg. I don't think I've ever given more than a total of 20mg over several hours.

I'm sure p.o. dosing is different, but 40mg IV? Seems like an awful lot to me ...

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

When my thyroid was extremely overactive last year, I was taking 150mg of Lopressor by mouth daily to control my seemingly uncontrollable pulse. I would awaken each morning with a pulse of 120 beats per minute, and the 150mg dose of Lopressor would drop my heart rate to about 80 beats per minute while stopping the fluttery palpitations. Lopressor (metoprolol) was good for me because I experienced no adverse reactions while taking it over the years.

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i had complete labs and my thyroid was ok except for my cholesterol.

When my thyroid was extremely overactive last year, I was taking 150mg of Lopressor by mouth daily to control my seemingly uncontrollable pulse. I would awaken each morning with a pulse of 120 beats per minute, and the 150mg dose of Lopressor would drop my heart rate to about 80 beats per minute while stopping the fluttery palpitations. Lopressor (metoprolol) was good for me because I experienced no adverse reactions while taking it over the years.
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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
i had complete labs and my thyroid was ok except for my cholesterol.
What a coincidence. It is the total opposite with me because my cholesterol was only 157 the last time it was checked, yet my poor thyroid was terribly out of whack as evidenced by the labs.
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Specializes in tele, stepdown/PCU, med/surg.

Maybe you metabolize it SO fast that it never can have it's greatest affect on you.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Maybe you metabolize it SO fast that it never can have it's greatest affect on you.
Yes, perhaps that is the case. I have noticed that hypothyroid people have elevated serum cholesterol, yet many hyperthyroid people have normal serum cholesterol.
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Specializes in Emergency.

Actually looking at my drug reference the dose range for hypertension for Lopessor is 100-400mg a day. In my typical work setting ER for MI we give 3-5mg doses each five mins apart. This is then follow an hour later if we haven't sent the pt to the cath lab with a 25-50mg PO dose. A dose wont be given if the HR is less than 60 or systolic BP

A question for the original poster- caffeine intake- how much? Anyway my next thought would to speak with your doctor about other options for slowing you heart rate to get this test done. Oddly trying another beta blocker might work. I have seen where a pateint responds poorly to one the next works better.

Rj

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i don't drink coffee and even my metabolism is fast still it should touch my hr because im in cont. cardiac monitoring and it did nothing. adenosine has a very short half life but still with my hyperthyroidim patient i can see some effects.

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