Esmolol Injection
Esmolol
Samarth Life Sciences Pvt Ltd
| Pack size | |
|---|---|
| Dispensing mode | |
| Source | |
| Agent | |
| Retail Price | 384.43 NPR |
Available as:
Indications
Esmolol Injection is used for:
Intraoperative Tachycardia/Hypertension, Postoperative/gradual control, Supraventricular Tachycardia, Hypertensive Emergency
Adult Dose
Intravenous
Adult:
Intraoperative Tachycardia/Hypertension
Immediate control
Initial bolus: 80 mg (~1 mg/kg) IVP over 30 sec, THEN
0.15-0.3 mg/kg/min IV infusion PRN
Postoperative/gradual control
Load 0.5 mg/kg IV over 1 min, THEN
0.05 mg/kg/min IV for 4 min
If inadequate response in 5 min
2nd loading dose of 0.5 mg/kg/min for 1 min, THEN
0.1 mg/kg/min IV
Supraventricular Tachycardia
Load: 0.5 mg/kg IV over 1 min, THEN
Maintenance: Start 0.05 mg/kg/min IV for 4 min, may increase by 0.05 mg/kg up to 0.2 mg/kg/min
If HR/BP not controlled after 5 min, repeat bolus (ie, 500 mcg/kg/min for 1 min), then initiate infusion of 0.1 mg/kg/min IV
May administer a 3rd bolus if needed, then a maintenance infusion of 0.15 mg/kg/min IV
Higher maintenance doses may be required, up to 0.25-0.3 mg/kg/min
Hypertensive Emergency
Load 0.25-0.5 mg/kg IVP over 1 min, THEN
0.05-0.1 mg/kg/min IV for 4 min
May repeat loading dose or increase infusion up to 0.3 mg/kg/min if necessary
Child Dose
Renal Dose
Renal Impairment
Not necessary to supplement dose; not dialyzable
Administration
IV Preparation
Solution: 5 g in 500 mL or 2.5 g in 250 mL NS (10 mg/mL)
IV Administration
Do NOT infuse into small veins or through butterfly catheter
Infuse at concentration 10 mg/mL, usually with infusion control device
If local reaction develops, change infusion site
Do not stop abruptly; possibility of withdrawal effects
Intended for short-term use, no longer than 48 hr
Contra Indications
Sinus bradycardia, 2nd and 3rd degree AV block, sick sinus syndrome, cardiogenic shock, overt cardiac failure, pulmonary HTN, untreated phaeochromocytoma, metabolic acidosis, severe asthma. Concomitant admin w/ vasoconstrictive and inotropic agents (e.g. epinephrine, norepinephrine, dopamine), IV Ca channel blockers (e.g. verapamil).
Precautions
Patients w/ inadequate cardiac function, well-compensated heart failure, bronchospastic disease, myasthenia gravis, conduction disorder, peripheral vascular disease. May mask signs and symptoms of hypoglycaemia and hyperthyroidism. Avoid abrupt withdrawal as it may precipate thyroid storm or MI, and may exacerbate angina and ventricular arrhythmias. Renal impairment. Pregnancy and lactation. Monitoring Parameters Monitor BP. Perform continuous ECG, monitor respiratory rate, serum K esp in patients w/ renal impairment.
Pregnancy-Lactation
Interactions
May increase serum digoxin levels. Additive effects w/ catecholamine-depleting drugs (e.g. reserpine). May prolong neuromuscular blockade of succinylcholine. May increase serum levels w/ morphine or warfarin. May decrease hypotensive effects w/ NSAIDs.
Potentially Fatal: May lead to fatal cardiac arrest w/ IV Ca channel blockers (e.g. verapamil). Increased risk of reducing cardiac contractility in presence of high systemic vascular resistance w/ vasoconstrictive or inotropic drugs (e.g. dopamine, norepinephrine, epinephrine).
Adverse Effects
Side effects of Esmolol :
>10%
Hypotension, asymptomatic (25-38%)
Hypotension, symptomatic (12%)
1-10%
Injection site pain (8%)
Nausea (7%)
Dizziness (3%)
Somnolence (3%)
Agitation (2%)
Confusion(2%)
Headache (2%)
Fatigue (1%)
Vomiting (1%)
<1%
Bradycardia
Chest pain
Anxiety
Anorexi
Depression
Abdominal discomfort
Constipation
Dry mouth
Dyspepsia
Taste perversion
Bronchospasm
Dyspnea
Nasal congestion
Wheezing
Mechanism of Action
Esmolol is a short-acting cardioselective agent, which competitively blocks beta1-adrenergic receptor while having little effect on the beta2-adrenergic receptors of bronchial and vascular smooth muscle. At high doses, selectivity usually diminishes, and the drug will competitively inhibit beta1- and beta2-adrenergic receptors.
Note
Esmolol Injection manufactured by Samarth Life Sciences Pvt Ltd. Its generic name is Esmolol. Esmolol is availble in Nepal.
Farmaco Nepal drug index information on Esmolol Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.