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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Should I Do To Treat Increased Resting Pulse Rate ?

I was in the ER this evening for a med reaction to metaprolol. I have COPD and it all of a sudden hit me like a ton of bricks to where i couldn t breathe . The EMT s gave me a breathing treatment on he ambulance , and I got a breathing treatment in the ER as well as steriods (it started with a D) in my IV. I have been super jittery ever since (no breathing treatment or steroid has ever made me this jittery for this long) and my resting pulse rate has remained at or just over 100 for 7 1/2 hours now. My chest wheeziness has diminished greatly and I can breathe in that manner but I am short of breath from my pulse being so high. I don t know whether to go back to the ER or not. I don t want to be a hypochondriac and go back for no reason. But at the same time I don t want my heart to explode. I was on the metaprolol for palpitations but was told to not take it anymore and to wait for my appointment with my cardiologist on Monday for a new medication for that.
Mon, 30 Apr 2012
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General & Family Physician 's  Response
Hello,
Beta Blockers are well known to produce increased bronchial obstruction and airway reactivity, and decreased response to inhaled or oral beta receptor agonists in patients with Bronchial Asthma but less often in patients with COPD.Usually a Beta-1 selective drug like Metaprolol is better tolerated & has lesser pulmonary side effects.

The jitteriness you describe is due to the beta agonists you would have received to relieve your bronchospasm.
Your palpitations can be due to 1)abrupt withdrawal of metoprolol which can result in acute tachycardia
2)Palpitations and Tachycardia can also be produced by beta agonists used for relieving bronchospasm.
Your cardiologist would be the ideal person to advise you regarding the replacement for Metoprolol based on your indication.
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What Should I Do To Treat Increased Resting Pulse Rate ?

Hello, Beta Blockers are well known to produce increased bronchial obstruction and airway reactivity, and decreased response to inhaled or oral beta receptor agonists in patients with Bronchial Asthma but less often in patients with COPD.Usually a Beta-1 selective drug like Metaprolol is better tolerated & has lesser pulmonary side effects. The jitteriness you describe is due to the beta agonists you would have received to relieve your bronchospasm. Your palpitations can be due to 1)abrupt withdrawal of metoprolol which can result in acute tachycardia 2)Palpitations and Tachycardia can also be produced by beta agonists used for relieving bronchospasm. Your cardiologist would be the ideal person to advise you regarding the replacement for Metoprolol based on your indication.