Difference between revisions of "Esmolol"
From WikiAnesthesia
Chris Rishel (talk | contribs) m (Added embedded dosage calculation) |
(Added onset of action and metabolism details, specifically RBC esterase metabolism.) |
||
| (2 intermediate revisions by 2 users not shown) | |||
| Line 7: | Line 7: | ||
| contraindications = | | contraindications = | ||
| routes = Intravenous | | routes = Intravenous | ||
| dosage = | | dosage = | ||
| dosage_calculation = esmolol | | dosage_calculation = esmolol | ||
| mechanism = Beta-1 antagonism | | mechanism = Beta-1 antagonism | ||
| adverse_effects = | | adverse_effects = Bradycardia, Hypotension | ||
| time_onset = | | time_onset = | ||
| duration = | | duration = | ||
| Line 20: | Line 20: | ||
}} | }} | ||
Esmolol is an ultrashort-acting selective β1-antagonist. It primarily decreases heart rate with less of an effect on blood pressure. <ref name=":0">{{Cite book|url=https://www.worldcat.org/oclc/1309921315|title=Morgan & Mikhail's clinical anesthesiology|date=2022|others=John F., IV Butterworth, David C. Mackey, John D. Wasnick|isbn=9781260473797|edition=Seventh edition|location=New York|oclc=1309921315}}</ref> | |||
== Uses<!-- Describe uses of the drug. If appropriate, add subsections for each indication. --> == | == Uses<!-- Describe uses of the drug. If appropriate, add subsections for each indication. --> == | ||
Treat/prevent perioperative tachycardia and hypertension . | |||
Opioid sparing anesthesia.<ref name=":0" /> | |||
== Contraindications<!-- List contraindications and precautions for use of the drug. --> == | == Contraindications<!-- List contraindications and precautions for use of the drug. --> == | ||
| Line 29: | Line 32: | ||
=== Precautions<!-- List precautions for use of the drug. If none, this section may be removed. --> === | === Precautions<!-- List precautions for use of the drug. If none, this section may be removed. --> === | ||
While it is cardioselective at lower doses, use higher doses cautiously in patients with bronchospastic disease. <ref name=":1">{{Cite web|title=UpToDate - Esmolol: Drug information|url=https://www.uptodate.com/contents/esmolol-drug-information?source=auto_suggest&selectedTitle=1~1---1~4---esmolol&search=esmolol#F166853|url-status=live|access-date=2022-12-21|website=www.uptodate.com}}</ref> | |||
Extreme caution should be used in patients with bradycardia, hypotension, greater than first degree heart block, cardiogenic shock or heart failure with reduced ejection fraction.<ref name=":0" /> Avoid in patients who recently received a calcium channel blocker. <ref name=":1" /> | |||
== Pharmacology == | == Pharmacology == | ||
| Line 35: | Line 41: | ||
==== Mechanism of action<!-- Describe the mechanism of action for the primary uses of the drug. --> ==== | ==== Mechanism of action<!-- Describe the mechanism of action for the primary uses of the drug. --> ==== | ||
At normal doses it is a selective β1-antagonist, at higher doses it also inhibits β2 receptors in both bronchial and vascular smooth muscle. <ref name=":0" /> | |||
==== Adverse effects<!-- Describe any potential adverse effects of the drug. --> ==== | ==== Adverse effects<!-- Describe any potential adverse effects of the drug. --> ==== | ||
=== Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. --> === | === Pharmacokinetics<!-- Describe the pharmacokinetics of the drug. --> === | ||
==== Onset of action ==== | |||
Beta-blockade with esmolol can be observed within 2-10 minutes of administration. Onset is typically quicker when administered as a bolus or with a loading dose prior to infusion.<ref name=":1" /> | |||
==== Metabolism ==== | |||
Esmolol is metabolized by red blood cell esterases to inactive metabolites, which are renally excreted. <ref name=":1" /> | |||
== Chemistry and formulation<!-- Describe the chemistry and formulation of the drug. --> == | == Chemistry and formulation<!-- Describe the chemistry and formulation of the drug. --> == | ||
Latest revision as of 09:07, 31 May 2023
Esmolol
| Trade names |
Brevibloc |
|---|---|
 | |
| Clinical data | |
| Drug class |
Beta blocker |
| Routes of administration |
Intravenous |
| Dosage | |
| Pharmacodynamics | |
| Mechanism of action |
Beta-1 antagonism |
| Adverse effects |
Bradycardia, Hypotension |
| Pharmacokinetics | |
| Physical and chemical data | |
| Article quality | |
| Editor rating | |
| User likes | 0 |
Esmolol is an ultrashort-acting selective β1-antagonist. It primarily decreases heart rate with less of an effect on blood pressure. [1]
Uses
Treat/prevent perioperative tachycardia and hypertension .
Opioid sparing anesthesia.[1]
Contraindications
Absolute contraindications
Precautions
While it is cardioselective at lower doses, use higher doses cautiously in patients with bronchospastic disease. [2]
Extreme caution should be used in patients with bradycardia, hypotension, greater than first degree heart block, cardiogenic shock or heart failure with reduced ejection fraction.[1] Avoid in patients who recently received a calcium channel blocker. [2]
Pharmacology
Pharmacodynamics
Mechanism of action
At normal doses it is a selective β1-antagonist, at higher doses it also inhibits β2 receptors in both bronchial and vascular smooth muscle. [1]
Adverse effects
Pharmacokinetics
Onset of action
Beta-blockade with esmolol can be observed within 2-10 minutes of administration. Onset is typically quicker when administered as a bolus or with a loading dose prior to infusion.[2]
Metabolism
Esmolol is metabolized by red blood cell esterases to inactive metabolites, which are renally excreted. [2]
Chemistry and formulation
History
References
- ↑ 1.0 1.1 1.2 1.3 Morgan & Mikhail's clinical anesthesiology. John F., IV Butterworth, David C. Mackey, John D. Wasnick (Seventh edition ed.). New York. 2022. ISBN 9781260473797. OCLC 1309921315.
|edition=has extra text (help)CS1 maint: others (link) - ↑ 2.0 2.1 2.2 2.3 "UpToDate - Esmolol: Drug information". www.uptodate.com. Retrieved 2022-12-21.