Esmolol Hydrochloride
Esmolol Hydrochloride is a beta-1 selective (cardioselective) adrenergic receptor blocking agent with rapid onset, a very short duration of action, and no significant intrinsic sympathomimetic or membrane stabilizing activity at therapeutic dosages. Its elimination half-life after intravenous infusion is approximately 9 minutes. Esmolol Hydrochloride inhibits the beta 1 receptors located chiefly in cardiac muscle, but this preferential effect is not absolute and at higher doses it begins to inhibit beta 2 receptors located chiefly in the bronchial and vascular musculature.
Administer intravenously. Titrate using ventricular rate or blood pressure at ≥4 minute intervals. Supraventricular tachycardia (SVT) or noncompensatory sinus tachycardia-Optional loading dose: 500 mcg per kg infused over one minuteThen 50 mcg per kg per minute for the next 4 minutesAdjust dose as needed to a maximum of 200 mcg per kg per minuteAdditional loading doses may be administeredPerioperative tachycardia and hypertension-Loading dose: 500 mcg per kg over 1 minute for gradual control (1 mg per kg over 30 seconds for immediate control).Than 50 mcg per kg per minute for gradual control (150 mcg per kg per minute for immediate control) adjusted to a maximum of 200 (tachycardia) or 300 (hypertension) mcg per kg per minute.
Digitalis glycosides: Risk of bradycardiaAnticholinesterases: Prolongs neuromuscular blockadeAntihypertensive agents: Risk of rebound hypertensionSympathomimetic drugs: Dose adjustment neededVasoconstrictive and positive inotropic effect substances: Avoid concomitant use
Severe sinus bradycardiaHeart block greater than first degreeSick sinus syndromeDecompensated heart failureCardiogenic shockCoadministration of IV cardiodepressant calcium-channel antagonists (e.g. verapamil) in close proximity to Esmolol hydrochloridePulmonary hypertensionKnown hypersensitivity to esmolol
Most common adverse reactions (incidence> 10%) are symptomatic hypotension (hyperhidrosis, dizziness) and asymptomatic hypotension.
Pregnancy Category C. Esmolol hydrochloride has been shown to produce increased fetal resorptions with minimal maternal toxicity in rabbits when given in doses approximately 8 times the maximum human maintenance dose (300 mcg/kg/min). There are no adequate and well-controlled studies in pregnant women. Esmolol Hydrochloride should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants from Esmolol Hydrochloride, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Risk of hypotension, bradycardia, and cardiac failure: Reduce or discontinue useRisk of exacerbating reactive airway diseaseDiabetes mellitus: Increases the effect of hypoglycemic agents and masks hypoglycemic tachycardiaRisk of unopposed alpha-agonism and severe hypertension in untreated pheochromocytomaRisk of myocardial ischemia when abruptly discontinued in patients with coronary artery disease
Anti adrenergic agent (Beta blockers)
Keep below 25°C temperature, away from light & moisture. Keep out of the reach of children.
Pediatric Use: The safety and effectiveness of Adrebloc in pediatric patients have not been established.Geriatric Use: Clinical studies of Adrebloc did not include sufficient numbers of subjects aged 65 and over to determine whether they responded differently from younger subjects.Hepatic Impairment: No special precautions are necessary in patients with hepatic impairment because Adrebloc is metabolized by red-blood cell esterases.Renal Impairment: No dosage adjustment is required for esmolol in patients with renal impairment receiving a maintenance infusion of esmolol 150 mcg/kg for 4 hours.
{'Indications': 'Adrebloc is a beta adrenergic blocker indicated for the short-termtreatment of:Control of ventricular rate in supraventricular tachycardia including atrial fibrillation and atrial flutter and control of heart rate in noncompensatory sinus tachycardia.Control of perioperative tachycardia and hypertension.'}