As a highly selective β 1 receptor blocker, bisoprolol fumarate tablets (Maintea) are mainly used for the treatment of hypertension and angina pectoris. Their effects include cardiovascular protection and hemodynamic improvement. Drug interactions should focus on the risks of liver enzyme inhibitors and cardiovascular drug combination therapy.

1. Effect of action

(1) Hypotensive effect: By inhibiting β 1 receptors, cardiac output and renin release are reduced, resulting in stable blood pressure reduction for 24 hours.

(2) Anti angina: reduces myocardial oxygen consumption and improves coronary artery blood flow reserve.

(3) Cardiac protection: reduce mortality rate in patients with myocardial infarction and improve left ventricular remodeling.

2. Drug interactions

(1) CYP3A4 inhibitor

Clarithromycin, itraconazole, and other drugs can increase the blood concentration of bisoprolol, and heart rate and blood pressure need to be monitored.

(2) Combination therapy of antihypertensive drugs

Combination with calcium antagonists may enhance negative inotropic effects, and intravenous combination of verapamil is prohibited.

(3) Hypoglycemic drugs

It may cover the symptoms of hypoglycemia, and insulin dependent diabetes patients need to strengthen blood glucose monitoring.

(4) Non steroidal anti-inflammatory drugs

Indomethacin and other drugs may antagonize the antihypertensive effect, and the dosage of bisoprolol needs to be adjusted.

(5) Other interactions

Combined use with digoxin increases the risk of atrioventricular block; MAOI drugs need to be used every 14 days.

3. Principles of post vomiting treatment

(1) Vomiting immediately after taking medication (within 30 minutes): It is recommended to take the full dose.

(2) Vomiting after taking medication for more than 30 minutes: usually no need to supplement, just take the next dose according to the original plan.

(3) Frequent vomiting: It is necessary to seek medical evaluation to determine whether dosage adjustment or medication replacement is necessary.

4. Precautions

(1) Monitoring blood pressure and heart rate: Vomiting may lead to dehydration, exacerbating the antihypertensive effect of beta blockers.

(2) Electrolyte balance: Long term vomiting requires checking blood potassium concentration, as low potassium may induce arrhythmia.

(3) Improvement of medication method: It is recommended to take it together with food or in divided doses to reduce irritation.