Esmolol

Esmolol Brand Name– Brevibloc

What is Esmolol

Esmolol is an extremely short-acting beta₁-selective beta-blocker. However, unlike other beta₁-selective beta-blockers (e.g., metoprolol, atenolol), esmolol is administered via continuous IV infusion.

Because of the extremely short duration of action of esmolol, it is useful for acute control of hypertension or certain supraventricular arrhythmias.

Esmolol was approved by the FDA in 1986 for the acute, temporary control of ventricular rate in certain supraventricular arrhythmias such as sinus tachycardia and atrial flutter and/or fibrillation in the perioperative, postoperative, or emergency setting.

Nonapproved indications include short-term control of perioperative hypertension, management of tachyarrhythmias complicating acute MI, and minimization of acute myocardial ischemia secondary to acute MI or unstable angina.

Indications

1. acute myocardial infarction
2. atrial fibrillation
3. atrial flutter
4. hypertensive emergency
5. hypertensive urgency
6. paroxysmal supraventricular tachycardia (PSVT)
7. perioperative hypertension
8. postoperative hypertension
9. unstable angina

For short-term control of supraventricular tachyarrhythmias, including sinus tachycardia or paroxysmal supraventricular tachycardia (PSVT), or to control ventricular rate in patients with atrial fibrillation or atrial flutter

Side Effects

1. abdominal pain
2. agitation
3. anorexia
4. anxiety
5. asthenia
6. AV block
7. bradycardia
8. bronchospasm
9. cardiac arrest
10. chest pain (unspecified)
11. confusion
12. constipation
13. depression
14. diaphoresis
15. dizziness
16. drowsiness
17. dysgeusia
18. dyspepsia
19. dyspnea
20. fatigue
21. fever
22. flushing
23. headache
24. hyperglycemia
25. hypoglycemia
26. hypotension
27. injection site reaction
28. nasal congestion
29. nausea
30. pallor
31. paresthesias
32. phlebitis
33. pulmonary edema
34. seizures
35. skin necrosis
36. syncope
37. tissue necrosis
38. vomiting
39. wheezing
40. xerostomia

Monitoring Parameters

• blood pressure
• heart rate
• serum electrolytes

Contraindications

• abrupt discontinuation
• acute bronchospasm
• acute heart failure
• asthma
• AV block
• beta-blocker hypersensitivity
• bradycardia
• breast-feeding
• bronchitis
• cardiogenic shock
• cerebrovascular disease
• chronic obstructive pulmonary disease (COPD)
• diabetes mellitus
• emphysema
• extravasation
• geriatric
• hyperthyroidism
• hypotension
• labor
• myasthenia gravis
• obstetric delivery
• peripheral vascular disease
• pheochromocytoma
• pregnancy
• pulmonary disease
• pulmonary edema
• Raynaud’s phenomenon
• renal disease
• renal failure
• renal impairment
• sick sinus syndrome
• thyroid disease
• thyrotoxicosis
• vasospastic angina
• ventricular dysfunction

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