| Drug | Esmolol |
| Brand names | Brevibloc ® |
| Indications | Short-term control of ventricular rate (including perioperative tachycardia) and hypertension (including hypertensive emergency, perioperative hypertension). |
| Mechanism of action | • Relatively cardioselective (beta-1 receptor blocker) beta-blocker with ultra-short acting effect.
• Half-life: 9 minutes. |
| Effects | • Esmolol is a beta-adrenergic receptor blocker.
• Esmolol lowers blood pressure immediately (within 1 minute)
• Esmolol may also be used to control supraventricular tachycardia (rate control).
• Esmolol may be used to reduce myocardial ischemia in the CCU or ICU. |
| Time to onset of action | 1 minute |
| Duration of action | 20-30 minutes |
| Delivery | IV |
| Dose | Loading dose: 500 μg/kg bolus over 1 minute.
Infusion start dose: 25–50 μg/kg/min.
Maximum infusion dose: 300 μg/kg/min.
Bolus doses of 300 μg/kg can be repeated during infusion. |
| Adverse effects | Flushing. Nausea. Bronchospasm. AV-block. |
| Caution | • Avoid in acute heart failure.
• May cause bradycardia. |
