Metoprolol

So it includes atojapan, eptanizumab, freminizumab, propranolol, Remedipant, Topiramate, and Valproate.

And then a slightly longer list for the low-confidence drugs, so Amitriptyline, Bizoprolol, Flunarazine, Fluoxetine, Levotiracetam, Metoprolol, Nifedipine, Pizodafin.

and telmisartan.

And for this outcome, I'm specifically talking about episodic migraine headache days.

Okay, blood pressure is high.

Let's give you some medication, Metaprolol and Lodipine or something and send you home.

Nobody really chats.

And if you go to a nephrologist, they can check all the urinary metanephrine levels, seeing that whether you have a renal hypertension or not or, you know, artysthenosis and rule out, okay, well, this is nothing, okay.

And with those members of the team, any patient who has a gradient that's in the severe range, which typically we think of as greater than 50 millimeters of mercury, and has symptoms, those are patients who we would enter into an algorithm of trying first-line pharmacologic therapy.

And with the data that's accumulated thus far that I alluded to earlier, including maple, we usually start with a beta blocker or a calcium blocker, but we don't typically ramp up the dose to extreme levels anymore, 200 milligrams of Toprol, for example.

We typically try a low dose, moderate dose, see how the patient feels.

If they have symptomatic improvement, functional improvement objectively, then we let them be.

That's a metoprolol succinate medication for blood pressure, right?

Yes.

Now, Toprol XL looks like a normal tablet, but structurally, it's a carrier vehicle for thousands of microscopic time-release shifts.

The API is divided into a multitude of tiny, individually polymer-coated pellets, which are then compressed into the main tablet.

So when you swallow it, the main tablet quickly disintegrates in your stomach.

I mean, you know, and I'm not one to talk a lot about like real specific things, but I will say that just from a medication standpoint, you know, I'm...

When the first thyroid thing happened and I was diagnosed, that was 2012, and they initially put me on Lopressor, and I'm on what I call a baby dose of it now.

But I mean, at one point early on in my journey, I was on 150 milligrams of that a day, which is a really high dose.

12 and a half grams now.

Or make my asthma bad.

But I actually found Metoprolol, which works for pe- a lot of cardiac, a lot of people who's got lung problems.

And I'm on three tablets a day, and I'm fine with it.

But I was on high strength of Entresto before I went on my device.

Certain drugs can cause gait changes that makes falls more likely or make people feel weak or off balance.

They include muscle relaxants such as Amarix, some high blood pressure medications such as beta blockers like Lopressor and Toprol.

coreg or gabapentin, which is used for anxiety, pain relief, and restless leg syndrome.

Number three, fatigue.

Very good.

Metoprolol slows the heart rate through beta one blockade, while verapamil slows conduction through the AV node.

Together, they can cause significant bradycardia or even complete heart block.

Diltiazem is also a non-dihydropyridine calcium channel blocker that can produce the same type of interaction, as opposed to something like amlodipine, which is a dihydropyridine and acts more on blood vessels for blood pressure control and doesn't have the same AV slowing effect.