Generic Name:

Esmolol

Trade Name:

Brevibloc

Actions:

Beta Adrenergic Antagonist

Indications:

Supraventricular Tachycardia

Unstable Angina

To determine effects of beta blocker therapy in unstable patients

Administration Guidelines:

Usual Dose And Route

INITIAL OR LOADING DOSE MUST BE ADMINISTERED

IN THE PRESENCE OF A PHYSICIAN

LOADING DOSE: 20 - 30mg ivp over 1 minute using the 10 mg/ml 10 ml vial. loading doses may be given prior to each incremental dosage adjustment. as therapeutic endpoint is approached, further loading doses should be avoided.

*LOADING DOSE IS USUALLY GIVEN PRIOR TO STARTING MAINTENANCE

MAINTENANCE DOSE: 2 To 12 Mg / Min as titrated to patient response. maintenance infusions may be increased by 2 to 3 mg/min at 10 minute intervals until desired response is achieved.

Standard Concentration:

2000mg /100 ml (central line preferred)

EW Standard

2000mg /100 ml (central line preferred)

Suggested Maximum Dose:

21 mg/min (300 mcg/kg/min). Within 24 hours after instituting esmolol therapy, a longer acting beta blocker should be substituted.

Special Considerations:

- PA-line monitoring of cardiac output, cardiac index, PCWP, CVP, SVR, is encouraged during maintenance infusions

- Doses exceeding 300 mcg/kg/min (ie. 21 mg/min for a 70 kg person) are discouraged due to lack of data of any increased efficacy and loss of unique pharmacokinetic properties.

Precautions And Side Effects:

- Bradycardia, AV block

- Bronchospasm

- Hypotension

- Cardiac Failure

- CNS Depression, Hallucinations