Esmolol Hydrochloride

Generic Details

Generic Name

Esmolol Hydrochloride

Other Names

  • Brevibloc

Drug Class

  • Beta-1 selective adrenergic antagonist
  • Antiarrhythmic agent

Chemical Formula

C16H25NO4.HCl

Molecular Weight

331.83 g/mol

Mechanism of Action

  • Esmolol selectively blocks beta-1 adrenergic receptors, leading to a decrease in heart rate and blood pressure.

Indications

  • Supraventricular tachycardia
  • Atrial fibrillation/flutter
  • Hypertension in surgery or emergent situations
  • Control of tachycardia in critical care setting

Common Dosage Forms

  • Injection

Typical Dosage

  • Initial dose: 500 mcg/kg intravenous bolus over 1 minute, followed by continuous infusion at 50-300 mcg/kg/minute

Pediatric Dosage

  • Safety and efficacy not established

Geriatric Dosage

  • Dose reduction may be needed due to age-related changes in pharmacokinetics

Side Effects

  • Hypotension
  • Bradycardia
  • Heart block
  • Bronchospasm
  • Fatigue
  • Nausea

Contraindications

  • 2nd or 3rd degree heart block
  • Cardiogenic shock
  • Severe bradycardia
  • Known hypersensitivity to esmolol or other beta-blockers

Pregnancy Category

  • C

Lactation Safety

  • L3 - Moderately Safe

Drug Interactions

  • Caution with other antiarrhythmic drugs
  • Potentiation of hypotensive effects with calcium channel blockers
  • Increased risk of bradycardia with concomitant use of beta-blockers

Overdose Symptoms

  • Severe bradycardia
  • Hypotension
  • Heart block

Antidote for Overdose

  • Atropine for bradycardia
  • Intravenous glucagon for refractory hypotension

Storage Conditions

  • Store at controlled room temperature (20-25°C)

Pharmacokinetics

  • Absorption: Rapidly metabolized after intravenous administration
  • Distribution: Quickly distributed in tissues
  • Metabolism: Mainly metabolized by ester hydrolysis in blood and tissues
  • Excretion: Primarily excreted in the urine as inactive metabolites

Precautions

  • Monitor heart rate and blood pressure continuously during administration
  • Use with caution in patients with bronchospastic diseases

Warnings

  • Abrupt withdrawal may exacerbate angina or precipitate a myocardial infarction

Others

  • Dosage adjustment may be necessary in patients with hepatic impairment or renal insufficiency