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Is 100mg Metoprolol Safe For Pulmonary Embolism?
Question: My mother came home from the hospital after a pulmonary embolism and was given 100mg metoprolol tartr to take 2 times a day? Is this too much? Now her home nurse said it is called her internist and has it changed to 100mg? Is this alright to change it so quickly?She is also having problems swallowing after being hospitalized. It seems to be a problem to even drink water. Will this go away?
Brief Answer:
Please read the detailed response
Detailed Answer:
Dear XXXX
Greetings from health care magic!!! I am Dr Thakker and shall be answering your question.
I can understand your concerns about your mother's health.
Betablocker Metoprolol has been given to her for controlling high blood pressure. It has no role in treatment of pulmonary embolism. The usual starting dose for Metoprolol is 25 mg and we can XXXXXXX it to 200 mg per day. However, one has to titrate the dose to her pulse. Metoprolol slows the heart rate. hence once it reaches 60/min we cant step it up further. I feel the dose 200 mg is very high. You need to tell me her pulse and BP on this high dose. if BP is controlled and pulse less then 60, we need to step down the dose to 100 per day.
I hope this helps you out. If you have any more questions, please do not hesitate to write back to me.
Yours sincerely,
Dr Thakker.
Please read the detailed response
Detailed Answer:
Dear XXXX
Greetings from health care magic!!! I am Dr Thakker and shall be answering your question.
I can understand your concerns about your mother's health.
Betablocker Metoprolol has been given to her for controlling high blood pressure. It has no role in treatment of pulmonary embolism. The usual starting dose for Metoprolol is 25 mg and we can XXXXXXX it to 200 mg per day. However, one has to titrate the dose to her pulse. Metoprolol slows the heart rate. hence once it reaches 60/min we cant step it up further. I feel the dose 200 mg is very high. You need to tell me her pulse and BP on this high dose. if BP is controlled and pulse less then 60, we need to step down the dose to 100 per day.
I hope this helps you out. If you have any more questions, please do not hesitate to write back to me.
Yours sincerely,
Dr Thakker.
Above answer was peer-reviewed by :
Dr. Yogesh D
She is also on coumedin and had a 5.8 . Yesterday, she was sitting in bed & sleeping at an angle. She also had some jumbling of some words which I couldn't understand. Today, she is complaining of her shoulder hurting and says that she can't lift her arm. When she does move her arm, she is crying out in pain. Do I need to worry about a stroke or some other problem considering her blood pressure & high coumedin level or could it just be the slanted position she was sleeping at. Thanks!
Brief Answer:
URGENT CT BRAIN
Detailed Answer:
Dear XXXX
I would be concerned that your mother has sustained a stroke secondary to a intracranial bleed. I would suggest that you have CT brain done on an urgent basis to rule out a bleed in her brain. warfarin is a blood thinner and is known to cause intra cranial bleeding.
also we need a fresh PT/INR. if this is more than 5, we need to give her vitamin k and fresh frozen plasma. all this needs inpatient hospital care. We also like to know here electrolyte levels.
I hope this helps you out. If you have any more questions, please do not hesitate to write back to me.
Yours sincerely,
Dr Thakker.
URGENT CT BRAIN
Detailed Answer:
Dear XXXX
I would be concerned that your mother has sustained a stroke secondary to a intracranial bleed. I would suggest that you have CT brain done on an urgent basis to rule out a bleed in her brain. warfarin is a blood thinner and is known to cause intra cranial bleeding.
also we need a fresh PT/INR. if this is more than 5, we need to give her vitamin k and fresh frozen plasma. all this needs inpatient hospital care. We also like to know here electrolyte levels.
I hope this helps you out. If you have any more questions, please do not hesitate to write back to me.
Yours sincerely,
Dr Thakker.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
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