Pharm

Esmolol

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Esmolol, Esmolol Hydrochloride, Brevibloc

  • See Also
  1. Beta Blocker
  • Indications
  1. Hypertensive Emergency (e.g. Aortic Dissection)
  2. Supraventricular Tachycardia
  • Mechanism
  1. Selective IV Beta Blocker
  • Indications
  1. Atrial Fibrillation Rate Control
  2. Emergent Hypertension Management
  • Pharmacokinetics
  1. Half-Life: 9 minutes
    1. Rapidly metabolized by erythrocyte esterase
  2. Duration of action: 15-20 minutes
  • Metabolism
  1. Renal Excretion
  2. Plasma levels are not affected by renal or hepatic dysfunction
  • Dosing
  • Intravenous
  1. Preparation: 2.5 g (10 ml ampule) in 250 ml (10 mg/ml)
  2. Load: 250-500 mcg/kg over 1 min (70 kg: 35 mg, 3.5 ml)
  3. Infusion:
    1. Start 25-50 mcg/kg/min IV (70 kg: 10 ml/h provides 25 mcg/kg/min)
    2. Titrate up 25-50 mcg/kg every 5 to 10 min to max 300 mcg/kg/min
  • Safety
  1. Pregnancy Category C
  2. Unknown safety in Lactation
  • Resources
  1. Esmolol (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=595cc3d5-1306-4828-aefa-5595219ffd62
  • References
  1. Hamilton (2010) Tarascon Pharmacopoeia, Jones and Bartlett, Boston
  2. Pevtsov (2022) Esmolol, StatPearls, Treasure Island, FL (accessed 12/25/2022)
    1. https://www.ncbi.nlm.nih.gov/books/NBK518965/