Esmolol
Trade names

Brevibloc

Esmolol.svg
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
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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. 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. 2.0 2.1 2.2 2.3 "UpToDate - Esmolol: Drug information". www.uptodate.com. Retrieved 2022-12-21.