Beta-adrenergic blockers include- Atenolol, Acebutol, Betaxolol, Bisoprolol,Cartelol,Esmolol,
                                                          Labetatol,Metoprolol, Nadolol,Penbutolol, Pinodol, Propranolol,
                                                          Solatol, Timolol,
                                                        Refer - Atenolol


Catecholamine-depleting drugs eg. resperine may have an additive effect when administered
with esmolol
Steady state blood level of esmolol is increased in the presence of morphine.
Esmolol prolongs the duration neuromuscular blockade by 5min to 8 min.
Esmolol should be titrated with caution in patients being treated concurrently with digoxin,
morphine, succinylchloine or morphine
Esmolol + verapramil can cause increased hypotension, AV block and fatal cardiac arrests.
 

Asymptomatic and symptomatic hypotension, diaphoresis, peripheral  ischema, dizziness,
somnlence, confusion, headache, agitation, fatigue, nausea, vomiting, pallor, flushing,

badycardia, chest pain, syncope, heart block, edema, depression, abnormal thinking, anxiety,
fever, lightheadedness, seizures, erythema, skin discoloration, anorexia, dyspepsia,

constipation, thrombophlebitis, infusion site reactions,paresthesia, rigors, miscapsular pain,
weakness, abnormal vision, bronchospasm, wheezing, dyspepsia, nasal congestion,
pulmonary edema.
 

Sinus bradycardia or herat block, uncompensated congestive heart failure, cardiogenic shock,
hypersensitivity to esmolol or other beta-blockers.

Special precautions:
Use with extreme caution in patients with hyper-reactive airway disease, diabetes mellitus,
hypoglycemia and renal failure.
Use lowest dose possible and discontinue with caution, if bronchospaam occurs.

Indications:
Short term treatment of supraventricular tachycardia.
Dosage:
Suprventricular tachycardia
IV 50-200mcg/kg/min (0.05- 0.2mg/kg/min)
Interoperative and postoperative tachycardia and/or hypotension
Immediate control 80mg(1mg/kg bolus dose over 30 seconds. followed by a 150mcg/kg/min
infusion if necessary
Gradual control- IV loading dose- 500mcg/kg/min.maintenance infusion of 50mcg/kg/min
 

Beta-adrenergic blockers include- Atenolol, Acebutol, Betaxolol, Bismoprolol,Cartelol,Esmolol, Labetatol,Metoprolol,
                                                 Nadolol,Penbutolol, Pinodol, Propranolol, Solatol, Timolol,
                                                 Refer - Atenolol


 

Pharmacology:
Esmolol plays an important role in perioperative control of blood pressure particularly in
situations requiring reversibility of effects. It blocks Beta1 adrenergic receptor. It shows rapid
onset and short duration of action, and no significant intrinsic sympathomimetic or membrane
stabilising activity at therapeutic dosages.

Pharmacokinetics:
Esmolol is rapidly metabolised by hydrolysis of the ester linkage, chiefly by the esterases in the
cytosol  of red blood cells. Esmolol has a rapid distribution half life of 2 min and an elimination
half-life of about 9 min.Steady state blood levels of esmolol for dosages from 50-300mcg/kg/min
(0.05- 0.3mg/kg/min) are obtained within 5 min. Because of its short half-life, blood levels of
esmolol can be rapidly eliminated by discontinuing the infusion. Less than 2% of the drug is
excreted unchanged in the urine.
 

Refer - Atenolol- Beta- adrenergic blocker