Esmolol

Details About Generic Salt ::  Esmolol 

Main Medicine Class:: Cardiovascular System   Sub Medicine Class ::  Anti Hypertensives

4D. ANTI-HYPERTENSIVES in 4. CARDIOVASCULAR SYSTEM
ESMOLOL
CARDIOSELECTIVE ß-BLOCKER | ANTI-ARRHYTHMIC, ANTI-HYPERTENSIVE
also comes under 4B. Anti-Arrhythmics in 4. Cardiovascular System
PK: D: 3.4 L/kg (Vd) E: Urine

Indications & Dose: HYPERTENSION IV Adult Initial bolus 80 mg (~1mg/kg) over 30 sec, followed by a 150µg/kg/min infusion, if necessary. Adjust infusion rate as needed to maintain desired HR and/or BP up to 300µg/kg/min | INTRA-OPERATIVE TACHYCARDIA IV Adult Initial bolus 80 mg (~1mg/kg) over 30 sec, followed by a 150µg/kg/min infusion, if necessary. Adjust infusion rate as needed to maintain desired HR and/or BP up to 300µg/kg/min | POSTOPERATIVE HYPERTENSION IV Adult 250-300µg/kg/min | SUPRAVENTRICULAR TACHYCARDIA/POSTOPERATIVE TACHYCARDIA IV Adult Loading dose: 500µg/kg over 1 min, followed with 50µg/kg/min inf for 4 min. Inf may be continued at 50µg/kg/min or if the response is inadequate titrate upward in 50µg/kg/min increments (increased no more frequently than q4min) to a max of 200µg/kg/min

Contra: Sinus bradycardia, heart block greater than first degree, cardiogenic shock, uncompensated cardiac failure, history of obstructive airways disease, metabolic acidosis, hypotension, severe peripheral arterial disease

Precautions: Renal impairment, DM, HF, PVD, myasthenia gravis, Pheochromocytoma, concurrent use of CCBs, avoid abrupt withdrawal

ADR: Serious: Symptomatic hypotension, asymptomatic HTN, peripheral ischemia, bradycardia, heart block, HF, hypoglycemia, changes in blood levels, triglycerides & cholesterol, Others: Dizziness, somnolence, confusion, headache, agitation, fatigue, nausea, vomiting, constipation, abdominal cramping, skin rash, pruritus, exacerbation of psoriasis, excess sweating, reversible alopecia

DDI: Serious Theophylline clearance reduced by drug, Clonidine leads to bradycardia & hypotension, Morphine raises drug levels

Monitor: BP, MAP, HR, continuous ECG, respiratory rate

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