The group of figures on the right is painted in a soft feathery style reminiscent of his work of the later 1870s, while the umbrellas and the couple on the left are painted in a harder manner with more distinct outlines and subdued steely colors.
Nitroprusside is light sensitive; both bottle and tubing should be wrapped in aluminum foil. Before initiating nitroprusside, administer a beta-blocker to counteract the physiologic response of reflex tachycardia that occurs when nitroprusside is used alone.This physiologic response increases shear forces against the aortic wall, thus increasing dP/dt. The objective is to keep the heart rate at 60-80 bpm.etoprolol (Lopressor, Toprol XL). Metoprolol is a selective beta1-adrenergic receptor blocker that decreases the automaticity of contractions. During IV administration, carefully monitor the blood pressure, heart rate, and electrocardiogram (ECG).
Beta-blockers are drugs that bind to beta-adrenoceptors and thereby block the binding of norepinephrine and epinephrine to these receptors. This inhibits normal sympathetic effects that act through these receptors. Therefore, beta-blockers are sympatholytic drugs. Some beta-blockers, when they bind to the beta-adrenoceptor, partially activate the receptor while preventing norepinephrine from binding to the receptor. These partial agonists therefore provide some background of sympathetic activity while preventing normal and enhanced sympathetic activity.