Esmolol

General

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

Pediatric Dosing

Special Populations

  • Pregnancy Rating:
  • 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
  • Blood Pressure control in Symptomatic Aortic Aneurysm
  • 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

References