Article Type : Research Article
Authors : Gawande N, Gaikwad O and Bodke V
Keywords : Pharmacovigilance; Metoprolol; ADR
Pharmacovigilance plays a key role in the
health system through the evaluation, monitoring and detection of drug
interactions and their impact on humans. . Therefore, drug safety requires
monitoring of adverse reactions for each drug throughout its life cycle, during
drug development, e.g. Pharmacovigilance deals with the detection, evaluation,
understanding and prevention of adverse effects Metoprolol Observational
studies suggest that beta-blockers may lower the risk of exacerbations and
death in patients with moderate or severe chronic obstructive pulmonary disease
(COPD), but randomized trials have not yet verified these findings. We can see
Metoprolol's MOA and ADR in all of their forms.
Pharmacovigilance has been outlined by the planet Health Organization as “The and activities with reference to the detection, assessment, understanding and hindrance of adverse effects or the other attainable drug-related drawback Objective
Objective
Class: Antihypertensive
? blocker
Mechanism of action
Metoprolol is an inhibitor of the beta-1-adrenergic
receptor that only works on cardiac cells and has no effect on the beta-2
receptors. Without exhibiting activity toward membrane stabilization or
intrinsic sympathomimetics, this inhibition reduces cardiac output through
negative chronotropic and inotropic effects.
Pharmacological Effect
Indications
Metoprolol is indicated for treatment of Angina
Adverse effect
Adverse effects, especially with higher doses, include
Precautions
Metoprolol might also additionally get worse the signs
and symptoms of heart failure in a few patients, who might also additionally
experience chest pain or discomfort, dilated neck veins, extreme fatigue, abnormal
breathing, an abnormal heartbeat, shortness of breath, swelling of the face,
fingers, feet, or decrease legs, weight gain, or wheezing
Pregnancy and
breastfeeding
Risk for the fetus has now no longer been dominated out, per being rated pregnancy class C in the United States .Metoprolol is class C in Australia, meaning that it is able to be suspected of causing dangerous consequences at the human fetus (however normal formations) [6]. It appears to besafein breastfeeding
Drug Interaction
Interactions between Two Drugs
Metoprolol
crosses the placenta
Any beta-adrenergic blocker, including metoprolol, can cause myocardial ischemia and other complications if stopped suddenly.
Selected Drug Consumption Report
(Metoprolol)
Adverse Drug Report of Metoprolol
Hospital visit
Name
of Doctor: - Dr. Madhuri R. Inamdar
Qualification:
- MBBS
How
much time you work in this place: - 3 year
Specialist
of doctor: - Physician & Consultant, Cardiologist specialist
Name
of Doctor: - Dr. Sambhaji Behere
Qualification:
- MBBS
How
much time you work in this place: - 5 year
Specialist
of doctor: - Physician & Consultant, Cardiologist specialist,
Patient interview
Name of patient: - Ms.Paramjeet Kaur Age-40, Sex- Female
Did
you suggest this treatment for another person which suffer from same condition?
Ans-
yes its helpful
What
other medicine do you take with this medicine?
Ans-
NO
Name
of patient: - Ms. Pallavi Kadam Age-36
Sex-Female
In
which condition you start the treatment?
Ans-
high Blood Pressure & chest pain
How
long you take this Drug/medicine?
Ans-from
90days
You
feel any discomfartness/side effect of this drug?
Ans-No
Tell
me about your medication history
Ans-
he has diabetics, he takes Glycomet 0.5 medicine from 3 year
Did
you suggest this treatment for another person which suffer from same condition?
Ans-
yess it’s helpful & feel good
What
other medicine do you take with this medicine?
Ans-
Zincovit tab
Name
of patient: - Mr.Vishnu Dadas Age-65,
Sex-Male
Naranjo scale
The Naranjo Scale was created by Naranjo et al. to
assess the chance that an adverse drug reaction (ADR) is caused by the drug
itself rather than by other factors. A score is used to categorise probability
as certain, probable, possible, or doubtful. Peer reviews frequently use the
values from this algorithm to validate the accuracy of an author's conclusions
about adverse drug reactions. The Naranjo Scale or Naranjo Score are other
names for it.
Metaprolol
Scoring
Due to unstable angina, the patient's BP ranged from
110/70 to 180/90 mm Hg, PR was 84 to 86 bpm, and SPO2 was 98%. After using the
aforementioned scales for the observed suspected ADR, the following result was
obtained: The patient was given the scales, and the scores were determined by
evaluating the ADR. Based on the results obtained utilising various standard
scales, causality was confirmed. Re-challenging was skipped because, according
to WHO-UMC, it is not necessary for likely medicines. The reaction was strange
form (Type-B) with a medium intensity of level 7, according to analysis. Most
likely, the reaction can be avoided [1-7] (Figures 1-5).
Metaprolol is the most widely used selective
beta-blocker antagonist. In healthy volunteers, the beta-blocker metoprolol
prevents sodium retention caused by negative pressure in the lower body despite
low blood pressure. The prevention of sodium retention may be due to weakened
neurohormonal responses. These effects of metoprolol on renal responses to LBNP
may partially explain the beneficial effects of this drug in patients with
heart failure......