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
- Follow this with infusion at 50mcg/kg/min for 4min
- Symptomatic AAA (controversial)
- 500mcg/kg bolus
- Infusion of 50-200mcg/kg/min titrated to goal SBP
Pediatric Dosing
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