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Metoprolol is a beta blocker, or an antagonist of the β-adrenergic receptors. It is specifically a selective antagonist of the β 1-adrenergic receptor and has no intrinsic sympathomimetic activity. [37] Metoprolol exerts its effects by blocking the action of certain neurotransmitters, specifically adrenaline and noradrenaline.
Figure 1: The chemical structure of dichloroisoprenaline or dichloroisoproterenol (), abbreviated DCI — the first β-blocker to be developed. β adrenergic receptor antagonists (also called beta-blockers or β-blockers) were initially developed in the 1960s, for the treatment of angina pectoris but are now also used for hypertension, congestive heart failure and certain arrhythmias. [1]
In some literature articles, the terms "mechanism of action" and "mode of action" are used interchangeably, typically referring to the way in which the drug interacts and produces a medical effect. However, in actuality, a mode of action describes functional or anatomical changes, at the cellular level, resulting from the exposure of a living ...
Adrenergic blocking agents are a class of drugs that exhibit its pharmacological action through inhibiting the action of the sympathetic nervous system [1] in the body. The sympathetic nervous system(SNS) is an autonomic nervous system that we cannot control by will.
Note that drugs may be cardioselective, or act on β 1 receptors in the heart only, but still have intrinsic sympathomimetic activity. Acebutolol (has intrinsic sympathomimetic activity, ISA) [80] Atenolol [80] Betaxolol [80] Bisoprolol [80] Celiprolol (has intrinsic sympathomimetic activity) [84] Metoprolol [80] Nebivolol [80] Esmolol [85]
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Via indirect action, it leads to an increase in acetylcholine production, stimulating M2 receptors on AV node leading to an overall decrease in speed of conduction. Magnesium sulfate is an antiarrhythmic drug, but only used against very specific arrhythmias [14] such as torsades de pointes. [15] [16]
The primary application for phentolamine is for the control of hypertensive emergencies, most notably due to pheochromocytoma. [5]It also has usefulness in the treatment of cocaine-induced cardiovascular complications, where one would generally avoid β-blockers (e.g. metoprolol), as they can cause unopposed α-adrenergic mediated coronary vasoconstriction, worsening myocardial ischemia and ...
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