Esmolol: Difference between revisions
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== Adult Dosing == | ==General== | ||
*Type: [[Beta blockers]] | |||
*Dosage Forms: | |||
*Common Trade Names: Brevibloc | |||
==Adult Dosing== | |||
*Loading dose = 500mcg/kg bolus over 1min | *Loading dose = 500mcg/kg bolus over 1min | ||
**Follow this | **Follow this with infusion at 50mcg/kg/min for 4min | ||
***If no response give another 500 bolus, | ***If no response give another 500 bolus, increased infusion to 100 | ||
***If no response give another 500 bolus, | ***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== | |||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C | |||
*Lactation: Unknown if excreted in breast milk | |||
*Renal Dosing | |||
**Adult: No adjustment required | |||
*Hepatic Dosing | |||
**Adult: No adjustment required | |||
==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | |||
*Cardiogenic shock | *Cardiogenic shock | ||
*2nd or 3rd AV block | *2nd or 3rd AV block | ||
== Indications == | ==Indications== | ||
*Supraventricular arrhythmias | *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 | |||
== Mechanism of Action == | ==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 | |||
== | ==Indications by Condition== | ||
''The following table is automatically generated from disease/condition pages across WikEM.'' | |||
== | {{#ask:[[Has DrugName::Esmolol]] | ||
|?Has Indication=Indication | |||
|?Has Dose=Dose | |||
|?Has Context=Context | |||
|?Has Route=Route | |||
|?Has Population=Population | |||
|format=table | |||
|headers=plain | |||
|mainlabel=- | |||
|sort=Has Indication | |||
|limit=50 | |||
}} | |||
==See Also== | ==See Also== | ||
[[Antiarrhythmics]] | *[[Beta-blockers]] | ||
*[[Beta-blocker toxicity]] | |||
*[[Antiarrhythmics]] | |||
*[[Antihypertensive medications]] | |||
==References== | |||
<references/> | |||
[[Category: | [[Category:Pharmacology]] | ||
[[Category:Cardiology]] | |||
[[Category:Critical Care]] | |||
Latest revision as of 21:55, 20 March 2026
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
Indications by Condition
The following table is automatically generated from disease/condition pages across WikEM.
| Indication | Dose | Context | Route | Population |
|---|---|---|---|---|
| Atrial fibrillation with RVR | 0.5mg/kg bolus over 1min, then 50-200mcg/kg/min | Rate control (beta-blocker); easily titratable | IV | Adult |
| Electrical storm | 300-500mcg/kg IV load over 1 min, then 25-50mcg/kg/min infusion | Sympathetic blockade | IV | Adult |
| Hypertensive emergency | 500 mcg/kg bolus then 50-300 mcg/kg/min | Antihypertensive (rate control) | IV drip | Adult |
| Nontraumatic thoracic aortic dissection | 0.5mg/kg bolus, then 50-200mcg/kg/min infusion | First-line heart rate control; easily titratable | IV | Adult |
| Paroxysmal supraventricular tachycardia | 500 mcg/kg IV over 60 sec; repeat bolus after 2-5 min if needed; then infusion 50-300 mcg/kg/min | Beta-blocker (short-acting, titratable) | IV/IV drip | Adult |
| Pulseless arrest | 500 mcg/kg over 30 sec | Refractory VF | IVP | Adult |
| Thyroid storm | 250-500 mcg/kg IV loading, then 50-100 mcg/kg/min drip | Beta-blocker (preferred if CHF/asthma) | IV drip | Adult |