Drug Reference
Rhythm
Metoprolol
β₁-selective blocker
IndicationAdult
IV rate controlAdult2.5–5 mg IV over 2 min; repeat every 5 min, max 15 mg
Indications
- AFib / flutter rate control
- SVT
- ACS (oral, after stabilization)
Contraindications & cautions
- Decompensated HF, cardiogenic shock
- Bradycardia / high-grade block
- Pre-excited AFib
- Cocaine-associated chest pain (relative)
- Severe bronchospasm
Key pearls
- IV β-blockers in STEMI with HF signs increase cardiogenic shock risk
- Glucagon reverses overdose