25 . February , 2018 - Sunday
Check todays hot topics or new products

Find a Drug: Advanced

Please Sign in or Register

All about: Esmolol HCl

Big Image Pronouncation: (ESS-moe-lahl HIGH-droe-KLOR-ide)
Class: Beta-adrenergic blocking agent

Trade Names:
Brevibloc
- Injection 10 mg/mL
- Injection 250 mg/mL

Mechanism of Action

Pharmacology

Blocks beta-receptors primarily affecting CV system (eg, decreases heart rate, contractility, BP) and lungs (promoting bronchospasm).

Pharmacokinetics

Distribution

Distribution t ½ is approximately 2 min. 55% is protein bound.

Metabolism

Rapidly metabolized by the esterases in the cytosol of red blood cells to an acid metabolite and methanol.

Elimination

The t ½ is approximately 9 min. Less than 2% excreted unchanged in the urine.

Indications and Usage

Short-term management of supraventricular tachyarrhythmias and noncompensatory sinus tachycardia.

Unlabeled Uses

Treatment of caffeine toxicity; attenuation of CV responses to electroconvulsive therapy or induction of anesthesia; adjunct therapy for acute MI and unstable angina; treatment of thyroid storm.

Contraindications

Sinus bradycardia; second- or third-degree heart block; CHF unless secondary to tachyarrhythmia treatable with beta-blockers; overt cardiac failure; cardiogenic shock.

Dosage and Administration

Adults

Usual: IV 500 mcg/kg/min for 1 min; then infusion of 50 to 200 mcg/kg/min, which has been titrated to desired end point (eg, heart rate, BP) in 50 mcg/kg/min increments.

General Advice

  • 10 mg/mL vial does not need further dilution.
  • Do not administer through butterfly needles.
  • For IV administration, use 250 mg/mL solution diluted in dextrose 5% injection and sodium chloride 0.9% or 0.45% injection, lactated Ringer's injection, and potassium chloride (40 mEq/L) in dextrose 5% injection or sodium chloride 0.9% or 0.45% injection. To prepare solution remove 20 mL from 500 mL bottle of suitable infusion fluid and add 2 amps of 250 mg/mL solution of esmolol. Final concentration is 10 mg/mL.

Storage/Stability

Store diluted solution at room temperature or under refrigeration. Discard after 24 h.

Drug Interactions

Clonidine

May enhance or reverse antihypertensive effect; potentially life-threatening increases in BP may occur, especially on withdrawal.

NSAIDs

Some agents may impair antihypertensive effect.

Prazosin

Potential for and degree of orthostatic hypotension may be increased.

Verapamil

Effects of both drugs may be increased.

Incompatibility

Sodium bicarbonate 5% injection.

Laboratory Test Interactions

Antinuclear antibodies may develop; usually reversible on discontinuation. May interfere with glucose or insulin tolerance test results. May cause changes in serum lipid levels.

Adverse Reactions

Cardiovascular

Hypotension; bradycardia; CHF; cold extremities; pallor; second or third-degree heart block.

CNS

Insomnia; fatigue; dizziness; depression; lethargy; drowsiness; forgetfulness.

Dermatologic

Rash; hives; fever; alopecia.

EENT

Dry eyes; blurred vision; tinnitus; slurred speech; sore throat.

GI

Nausea; vomiting, diarrhea; dry mouth.

Genitourinary

Impotence; painful, difficult, or frequent urination.

Hematologic

Agranulocytosis; thrombocytopenia purpura.

Respiratory

Bronchospasm; shortness of breath; wheezing.

Miscellaneous

Weight changes; facial swelling; muscle weakness; inflammation at infusion site.

Precautions

Pregnancy

Category C .

Lactation

Undetermined.

Children

Safety and efficacy not established.

Renal Function

Reduced daily dose advised.

Hepatic Function

Reduced daily dose advised.

Anaphylaxis

Deaths have occurred; aggressive therapy may be required.

CHF

Administer drug in patients with CHF controlled by digitalis and diuretics. Notify health care provider at first sign or symptom of CHF or other unexplained respiratory symptoms.

Diabetes mellitus

May mask signs and symptoms of hypoglycemia (eg, tachycardia, BP changes). May potentiate insulin-induced hypoglycemia.

Nonallergic bronchospasm (eg, chronic bronchitis, emphysema)

Use caution in patients with bronchospastic diseases.

Peripheral vascular disease

May precipitate or aggravate symptoms of arterial insufficiency.

Thyrotoxicosis

May mask clinical signs (eg, tachycardia) of developing or continuing hyperthyroidism. Abrupt withdrawal may exacerbate symptoms of hyperthyroidism, including thyroid storm.

Overdosage

Symptoms

Hypotension, bradycardia, intraventricular conduction disturbances, shock.

Patient Information

  • Caution patient to notify health care provider of any urticaria, shortness of breath, vertigo, syncope, or inability to void.
  • Advise diabetic patient to notify health care provider of hypoglycemic reaction symptoms.

Recent Drug Updates at DrugIndexOnline:





amitriptyline and perphenazine amitriptyline and perphenazine
Generic Name: amitriptyline and perphenazine (a mee TRIP ti leen/ per FEN a zeen) Brand Names: Etrafon 2-10, Etrafon 2-25, Etrafon Forte What is amitriptyline and perphenazine? Amitriptyline is in a class of drugs called tricyclic antidepressants. It is used to relieve symptoms of depres more...

CellCept Suspension CellCept Suspension
Generic Name: Mycophenolate Mofetil Oral Suspension (mye-koe-FEN-oh-late MOE-feh-til) Brand Name: CellCeptCellCept Suspension decreases your immune system, which may decrease your ability to fight illness or infection. It may also increase the risk of certain types of cancer (eg, lymphoma). Use more...

Chlorpheniramine/Dihydrocodeine/Phenylephrine Liquid Chlorpheniramine/Dihydrocodeine/Phenylephrine Liquid
Generic Name: Chlorpheniramine/Dihydrocodeine/Phenylephrine Liquid and Syrup (KLOR-fen-IR-a-meen/dye-HYE-droe-KOE-deen/FEN-il-EF-rin) Brand Name: Examples include Novahistine DH and Pancof PDChlorpheniramine/Dihydrocodeine/Phenylephrine Liquid is used for:Treating symptoms of the common cold, f more...

diltiazem and enalapril diltiazem and enalapril
Generic Name: diltiazem and enalapril (dil TYE a zem and e NAL a pril) Brand Names: Teczem What is diltiazem and enalapril? Diltiazem is in a class of drugs called calcium channel blockers. Diltiazem relaxes (widens) your blood vessels (veins and arteries), which makes it easier for your more...

Dureticyl Dureticyl
Some commonly used brand names are: In the U.S.— Demi-Regroton 5 Diupres 4 Diurigen with Reserpine 4 Diutensen-R 7 Enduronyl 2 Enduronyl Forte 2 Oreticyl 1 Oreticyl Forte 1 Rauzide 3 Regroton 5 In Canada— Dureticyl 2 Hydropres-50 6 Note: For quick reference, the following ra more...

Lenalidomide Lenalidomide
Generic Name: Lenalidomide (LEN-a-LID-oh-mide) Brand Name: Revlimid Lenalidomide may cause severe birth defects or death of the fetus if used during pregnancy. Lenalidomide is similar to thalidomide, which causes life-threatening birth defects. Females who are able to become pregnant and who t more...

Lindane shampoo Lindane shampoo
Dosage Form: Shampoo Rx only Warnings Lindane Shampoo should only be used in patients who cannot tolerate or have failed first-line treatment with safer medications for the treatment of lice. (See INDICATIONS AND USAGE.) Neurologic Toxicity Seizures and deaths have been reported following L more...

Morphine Immediate-Release Morphine Immediate-Release
Generic Name: Morphine Immediate-Release Tablets (MORE-feen) Brand Name: Generics only. No brands available.Morphine Immediate-Release is used for:Treating moderate to severe pain. Morphine Immediate-Release is a narcotic pain reliever. It works by dulling the pain perception center in the brai more...