In 2020, it was the sixth most commonly prescribed medication in the United States, with more than 66 million prescriptions. Medical uses
Metoprolol is used for a number of conditions, including hypertension, angina, acute myocardial infarction, supraventricular tachycardia, ventricular tachycardia, congestive heart failure, and prevention of migraine headaches. It is an adjunct in the treatment of hyperthyroidism.The different salt versions of metoprolol – metoprolol tartrate and metoprolol succinate – are approved for different conditions and are not interchangeable.Off-label uses include supraventricular tachycardia and thyroid storm. Available forms
Metoprolol is sold in formulations that can be taken by mouth or given intravenously. The medication is often taken twice a day. The extended-release formulation is taken once a day. Metoprolol may be combined with hydrochlorothiazide (a diuretic) in a single tablet. Adverse effects
Adverse effects, especially with higher doses, include dizziness, drowsiness, fatigue, diarrhea, unusual dreams, trouble sleeping, depression, and vision problems. β-blockers, including metoprolol, reduce salivary flow via inhibition of the direct sympathetic innervation of the salivary glands. Metoprolol may also cause the hands and feet to feel cold.
History
In 1861, Zenker first reported on the autopsy findings of fat droplets found in the lungs of a railway worker who died due to severe thoraco-abdominal crush injury. In 1873, Bergmann diagnosed fat embolism clinically in a patient with fractured femur. In 1970, Gurd defined the characteristics of this phenomenon. Gurd later modified the fat embolism criteria together with Wilson, thus producing Gurd and Wilsons criteria for fat embolism syndrome in 1974. In 1983, Schonfeld suggested a scoring system for the diagnosis of fat embolism syndrome. In 1987, Lindeque proposed another scoring system that diagnose fat embolism syndrome by using respiratory changes alone. However, none of them have become universally accepted in the medical community.In 2015, Singaporean couple Pua Hak Chuan and Tan Hui Zhen were charged with the abuse and murder of Annie Ee Yu Lian, who died due to multiple physical abuse which lasted for eight months before her death. The cause of death was revealed to be acute fat embolism, which resulted from the blunt force impact caused by the beatings, which led to the fatty tissue entering the bloodstream and eventually entering the blood vessels in the lungs, which led to a blockage and cut off the circulation of oxygenated blood and led to Ees death by respiratory and cardiac failure. Two years later, for reduced charges of voluntarily causing grievous hurt with a weapon, Tan was sentenced to 16 years and six months in jail while Pua received 14 years imprisonment and 14 strokes of the cane.