Esmolol

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	Unrated
User likes	0

Esmolol is an ultrashort-acting selective β1-antagonist. It primarily decreases heart rate with less of an effect on blood pressure.

Uses

Treat/prevent perioperative tachycardia and hypertension .

Opioid sparing anesthesia.

Contraindications

Precautions

While it is cardioselective at lower doses, use higher doses cautiously in patients with bronchospastic disease.

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. Avoid in patients who recently received a calcium channel blocker.

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.

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.

Metabolism

Esmolol is metabolized by red blood cell esterases to inactive metabolites, which are renally excreted.