Beta-adrenergic blockers like esmolol are prescribed for the temporary management of:
Continuous intravenous infusion is used to deliver esmolol hydrochloride, either with or without a loading dose.
The optional loading dose for patients with non compensatory sinus tachycardia or supraventricular tachycardia (SVT) is 50 mcg per kg per minute for the next four minutes after 500 mcg per kg per minute given over one minute. To a maximum of 200 mcg per kg per minute, adjust the dosage as necessary.
Patients who have both hypertension and perioperative tachycardia should be given a loading dose of 500 mcg per kg over one minute for gradual control (1 mg per kg over 30 seconds for immediate control). After that, they should receive 50 mcg per kg per minute for gradual control (150 mcg per kg per minute for immediate control), with the maximum being 200 mcg per kg per minute for tachycardia and 300 mcg per kg per minute for hypertension patients.
Symptomatic hypotension (dizziness, hyperhidrosis) and asymptomatic hypotension are the most often reported adverse effects (incidence > 10%) associated with esmolol.
Low Blood Pressure Monitoring: Keep a close eye on patients with low blood pressure before treatment. If their blood pressure drops too much after receiving esmolol, adjust or stop the injections.
Combining Medications Caution: When using beta blockers like esmolol with drugs for diabetes, be aware that it can make the diabetes medication stronger, potentially lowering blood sugar levels.
Monitoring Vital Signs: Pay special attention to vital signs and slowly adjust the dosage of esmolol for patients whose blood pressure is mainly affected by cold-related narrowing of blood vessels.
Heart Function Awareness: Esmolol, as a beta blocker, can weaken the heart’s pumping ability. If signs of heart failure appear, stop esmolol and provide supportive care.
Heart Rate Observation: Keep a check on the heart rate and rhythm for patients on esmolol treatment.
Injection Caution: Avoid infusing esmolol into small veins or through certain types of catheters to prevent reactions at the injection site and leakage into surrounding tissues.
Effects on Blood Pressure: In patients lacking sufficient blood volume, esmolol injections can reduce rapid heartbeat and increase the risk of low blood pressure.
Peripheral Circulatory Disorders Warning: For those with conditions like Raynaud’s disease or peripheral vascular disease, esmolol therapy might worsen these conditions.
Renal and Acidosis Concerns: Beta blockers, including esmolol, could lead to kidney-related acidosis, which might impact heart function due to increased acidity in the body.
What is Esmolol?
Esmolol is a medication classified as a cardio-selective beta-blocker. It’s known for its short-acting nature and falls under the class-II antiarrhythmic agents.
How does Esmolol work?
Esmolol acts by selectively blocking beta receptors in the heart. By doing so, it reduces the workload on the heart and helps regulate heart rhythm.
What conditions does Esmolol treat?
Esmolol is primarily used to manage rapid heart rate (tachycardia) and irregular heart rhythms (arrhythmias) that require immediate control.
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