https://wikianesthesia.org/w/api.php?action=feedcontributions&feedformat=atom&user=Jhollowa 2026-05-04T15:55:33Z User contributions MediaWiki 1.37.1 https://wikianesthesia.org/w/index.php?title=Esmolol&diff=15033 2023-05-31T17:07:54Z

<p>Jhollowa: Added onset of action and metabolism details, specifically RBC esterase metabolism.</p> <hr /> <div>{{Infobox drug reference<br /> | trade_names = Brevibloc<br /> | image_file = Esmolol.svg<br /> | drug_class = Beta blocker<br /> | drug_class_color = cardiovascular_antagonist<br /> | uses = <br /> | contraindications = <br /> | routes = Intravenous<br /> | dosage =<br /> | dosage_calculation = esmolol<br /> | mechanism = Beta-1 antagonism<br /> | adverse_effects = Bradycardia, Hypotension<br /> | time_onset = <br /> | duration = <br /> | metabolism = <br /> | halflife_redistribution = <br /> | halflife_elimination = <br /> | clearance = <br /> | protein_binding = <br /> }}<br /> <br /> Esmolol is an ultrashort-acting selective β1-antagonist. It primarily decreases heart rate with less of an effect on blood pressure. &lt;ref name=&quot;:0&quot;&gt;{{Cite book|url=https://www.worldcat.org/oclc/1309921315|title=Morgan &amp; Mikhail's clinical anesthesiology|date=2022|others=John F., IV Butterworth, David C. Mackey, John D. Wasnick|isbn=9781260473797|edition=Seventh edition|location=New York|oclc=1309921315}}&lt;/ref&gt;<br /> <br /> == Uses&lt;!-- Describe uses of the drug. If appropriate, add subsections for each indication. --&gt; ==<br /> Treat/prevent perioperative tachycardia and hypertension .<br /> <br /> Opioid sparing anesthesia.&lt;ref name=&quot;:0&quot; /&gt;<br /> <br /> == Contraindications&lt;!-- List contraindications and precautions for use of the drug. --&gt; ==<br /> <br /> === Absolute contraindications&lt;!-- List absolute contraindications for use of the drug. If none, this section may be removed. --&gt; ===<br /> <br /> === Precautions&lt;!-- List precautions for use of the drug. If none, this section may be removed. --&gt; ===<br /> While it is cardioselective at lower doses, use higher doses cautiously in patients with bronchospastic disease. &lt;ref name=&quot;:1&quot;&gt;{{Cite web|title=UpToDate - Esmolol: Drug information|url=https://www.uptodate.com/contents/esmolol-drug-information?source=auto_suggest&amp;selectedTitle=1~1---1~4---esmolol&amp;search=esmolol#F166853|url-status=live|access-date=2022-12-21|website=www.uptodate.com}}&lt;/ref&gt;<br /> <br /> Extreme caution should be used in patients with bradycardia, hypotension, greater than first degree heart block, cardiogenic shock or heart failure with reduced ejection fraction.&lt;ref name=&quot;:0&quot; /&gt; Avoid in patients who recently received a calcium channel blocker. &lt;ref name=&quot;:1&quot; /&gt;<br /> <br /> == Pharmacology ==<br /> <br /> === Pharmacodynamics&lt;!-- Describe the effects of the drug on the body. If appropriate, add subsections by organ system --&gt; ===<br /> <br /> ==== Mechanism of action&lt;!-- Describe the mechanism of action for the primary uses of the drug. --&gt; ====<br /> At normal doses it is a selective β1-antagonist, at higher doses it also inhibits β2 receptors in both bronchial and vascular smooth muscle. &lt;ref name=&quot;:0&quot; /&gt;<br /> <br /> ==== Adverse effects&lt;!-- Describe any potential adverse effects of the drug. --&gt; ====<br /> <br /> === Pharmacokinetics&lt;!-- Describe the pharmacokinetics of the drug. --&gt; ===<br /> <br /> ==== Onset of action ====<br /> Beta-blockade with esmolol can be observed within 2-10 minutes of administration. Onset is typically quicker when administered as a bolus or with a loading dose prior to infusion.&lt;ref name=&quot;:1&quot; /&gt;<br /> <br /> ==== Metabolism ====<br /> Esmolol is metabolized by red blood cell esterases to inactive metabolites, which are renally excreted. &lt;ref name=&quot;:1&quot; /&gt;<br /> <br /> == Chemistry and formulation&lt;!-- Describe the chemistry and formulation of the drug. --&gt; ==<br /> <br /> == History&lt;!-- Describe the historical development of the drug. --&gt; ==<br /> <br /> == References ==<br /> <br /> [[Category:Drug reference]]<br /> [[Category:Adrenergic receptor modulators]]<br /> [[Category:Beta blockers]]<br /> [[Category:Beta-1 antagonists]]<br /> [[Category:Chronotropes]]<br /> [[Category:Negative chronotropes]]</div>

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