Medical Information

As a selective β 1 receptor blocker, bisoprolol fumarate tablets require special attention to cardiovascular parameter monitoring, identification of contraindications, and special precautions when used. The following will explain from three aspects: core monitoring indicators, absolute contraindications, and medication detail management.

1. Core vital sign monitoring

(1) Heart rate monitoring: During the initial stage of medication, measure the resting heart rate daily and maintain an ideal target value of 55-60 beats per minute. If<50 episodes/minute or if there is grade II or above atrioventricular block, the medication should be stopped immediately.

(2) Blood pressure control: During the initial treatment phase, measure once in the morning and once in the evening, and the systolic blood pressure should not be less than 90mmHg. Patients with concomitant hypertension should pay attention to the risk of orthostatic hypotension.

2. Absolute contraindications

(1) Respiratory system: It is contraindicated for patients with bronchial asthma and acute exacerbation of chronic obstructive pulmonary disease, as it may induce fatal bronchospasm.

(2) Circulating system: Patients with cardiogenic shock, sick sinus syndrome, and third degree atrioventricular block without pacemakers are prohibited from using it.

3. Special medication management

(1) Discontinuation principle: Long term medication users need to gradually reduce their dosage, sudden cessation of medication may cause rebound angina. Suggest halving the dosage every 3 days until discontinuation.

(2) Combination therapy: Combination therapy with diltiazem and verapamil can enhance bradycardia, and should be administered at least 4 hours apart.

4. Precautions for high-risk groups

(1) Patients with diabetes: may cover up the symptoms of hypoglycemia, and it is recommended that the goal of blood glucose control be relaxed to 7-9mmol/L on an empty stomach.

(2) Peripheral vascular disease: Check the pulse intensity and skin temperature of the limbs every month. If intermittent claudication worsens, consider changing dressing.

5. Emergency situation handling

(1) Overdose treatment: Intravenous injection of atropine 0.5-1mg to combat bradycardia, and if necessary, intravenous infusion of glucagon 10mg.

(2) Surgical preparation: Start reducing medication 72 hours before the scheduled surgery to avoid synergistic inhibitory effects with anesthetic drugs.