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
- acute myocardial infarction
- atrial fibrillation
- atrial flutter
- hypertensive emergency
- hypertensive urgency
- paroxysmal supraventricular tachycardia (PSVT)
- perioperative hypertension
- postoperative hypertension
- 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
- abdominal pain
- agitation
- anorexia
- anxiety
- asthenia
- AV block
- bradycardia
- bronchospasm
- cardiac arrest
- chest pain (unspecified)
- confusion
- constipation
- depression
- diaphoresis
- dizziness
- drowsiness
- dysgeusia
- dyspepsia
- dyspnea
- fatigue
- fever
- flushing
- headache
- hyperglycemia
- hypoglycemia
- hypotension
- injection site reaction
- nasal congestion
- nausea
- pallor
- paresthesias
- phlebitis
- pulmonary edema
- seizures
- skin necrosis
- syncope
- tissue necrosis
- vomiting
- wheezing
- 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
Interactions
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