Esmolol
| 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. |