Home Drug Guide Bisoprolol Fumarate

Drug Guide

Generic Name

Bisoprolol Fumarate

Brand Names Zebeta

Classification

Therapeutic: Cardiovascular agent, antihypertensive, beta-blocker

Pharmacological: Beta-1 selective adrenergic receptor blocker

FDA Approved Indications

  • Hypertension
  • Angina pectoris

Mechanism of Action

Bisoprolol selectively blocks beta-1 adrenergic receptors in the heart, decreasing heart rate, cardiac output, and blood pressure, thereby reducing myocardial oxygen demand.

Dosage and Administration

Adult: Typically 5 mg once daily, adjustable up to 20 mg based on response.

Pediatric: Not indicated for pediatric use.

Geriatric: Start at lower dose, titrate cautiously due to potential increased sensitivity.

Renal Impairment: Adjust dosage based on severity; close monitoring advised.

Hepatic Impairment: Use with caution; no specific dosage adjustment established.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed; bioavailability approximately 90%.

Metabolism: Minimal hepatic metabolism.

Excretion: Renal excretion of unchanged drug and metabolites.

Half Life: Approximately 10-12 hours.

Contraindications

  • Absolute: Sinus bradycardia, second- or third-degree AV block, cardiogenic shock, overt cardiac failure.
  • Precautions: Asthma, COPD, peripheral vascular disease, diabetes mellitus, thyrotoxicosis, and patients on other antihypertensive therapy.

Precautions

  • Use with caution in patients with respiratory conditions due to risk of bronchospasm; monitor blood glucose in diabetics.

Adverse Reactions - Common

  • Fatigue (Common)
  • Dizziness (Common)
  • Bradycardia (Common)

Adverse Reactions - Serious

  • Severe bradycardia or heart block (Rare)
  • Worsening heart failure (Rare)
  • Bronchospasm in susceptible individuals (Rare)

Drug-Drug Interactions

  • Other antihypertensives, calcium channel blockers, antiarrhythmic agents, insulin and antidiabetics (may mask hypoglycemia)

Drug-Food Interactions

  • Alcohol may enhance hypotensive effects.

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, heart rate, and respiratory status regularly. Assess for signs of heart failure.

Diagnoses:

  • Risk for decreased cardiac output
  • Risk for falls related to hypotension and dizziness.

Implementation: Administer sunrise; monitor HR and BP; caution with abrupt discontinuation.

Evaluation: Assess whether blood pressure and heart rate are controlled and adjust therapy accordingly.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Notify healthcare provider if symptoms of bradycardia, dizziness, or shortness of breath occur.
  • Do not discontinue abruptly.
  • Limit alcohol intake.
  • Monitor blood glucose if diabetic.

Special Considerations

Black Box Warnings:

  • Abrupt discontinuation can exacerbate angina and increase risk of myocardial infarction.

Genetic Factors: Consider pharmacogenetic variability in beta-blocker response.

Lab Test Interference: May mask hypoglycemia symptoms in diabetics.

Overdose Management

Signs/Symptoms: Severe bradycardia, hypotension, heart failure, bronchospasm, hypoglycemia.

Treatment: Administer activated charcoal if recent ingestion; vasopressors and atropine for bradycardia; glucagon may be used in overdose with beta-blockers.

Storage and Handling

Storage: Store at room temperature, away from moisture and light.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.