Esmolol

General

• Type: Beta blockers
• Dosage Forms:
• Common Trade Names: Brevibloc

Adult Dosing

• Loading dose = 500mcg/kg bolus over 1min
  • Follow this with infusion at 50mcg/kg/min for 4min
    • If no response give another 500 bolus, increased infusion to 100
    • If no response give another 500 bolus, increased infusion to 200

• Symptomatic AAA (controversial)
  • 500mcg/kg bolus
  • Infusion of 50-200mcg/kg/min titrated to goal SBP

Special Populations

• Pregnancy Rating: C
• Lactation: Unknown if excreted in breast milk
• Renal Dosing
  • Adult: No adjustment required
• Hepatic Dosing
  • Adult: No adjustment required

Contraindications

• Allergy to class/drug
• Cardiogenic shock
• 2nd or 3rd AV block

Indications

• Supraventricular arrhythmias
• Heart rate and blood pressure control in Symptomatic Aortic Aneurysm (titrate to HR <60 bmp)
• Off label use: refractory VF

Adverse Reactions

• Hypotension
• Bronchospasm

Pharmacology

• Half-life: Adults - 9min Children 18mo-16yrs 2.7-4.8min
• Metabolism: Red Blood Cell Esterase
• Excretion: Renal
• Mechanism of Action: Class II - Short-acting Beta1 blocker
• Onset of action = 1-4min
• Duration of action = <30min

See Also

• Beta-blockers
• Beta-blocker toxicity
• Antiarrhythmics
• Antihypertensive medications