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|Esmolol HCl |
Drugs search, click the first letter of a drug name: | A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | 1 | 2 | 3 | 4 | 5 | 6 | 8 | 9 Home Esmolol HClPronouncation: (ESS-moe-lahl HIGH-droe-KLOR-ide)Class: Beta-adrenergic blocking agent Trade Names: Mechanism of ActionPharmacologyBlocks beta-receptors primarily affecting cardiovascular system (eg, decreases heart rate, contractility, BP) and lungs (promoting bronchospasm). PharmacokineticsDistributionDistribution t 1/2 is approximately 2 min. 55% is protein bound. MetabolismRapidly metabolized by the esterases in the cytosol of red blood cells to an acid metabolite and methanol. EliminationThe t 1/2 is approximately 9 min. Less than 2% excreted unchanged in the urine. Indications and UsageShort-term management of supraventricular tachyarrhythmias and noncompensatory sinus tachycardia. Unlabeled UsesTreatment of caffeine toxicity; attenuation of cardiovascular responses to electroconvulsive therapy or induction of anesthesia; adjunct therapy for acute MI and unstable angina; treatment of thyroid storm. ContraindicationsSinus bradycardia; second- or third-degree heart block; CHF unless secondary to tachyarrhythmia treatable with beta-blockers; overt cardiac failure; cardiogenic shock. Dosage and AdministrationAdultsUsual: IV 500 mcg/kg/min for 1 min; then infusion of 50 to 200 mcg/kg/min, which has been titrated to desired endpoint (eg, heart rate, BP) in 50 mcg/kg/min increments. General Advice
Storage/StabilityStore diluted solution at room temperature or under refrigeration. Discard after 24 hr. Drug InteractionsClonidineMay enhance or reverse antihypertensive effect; potentially life-threatening increases in BP may occur, especially on withdrawal. NSAIDsSome agents may impair antihypertensive effect. PrazosinPotential for and degree of orthostatic hypotension may be increased. VerapamilEffects of both drugs may be increased. Incompatibility5% Sodium Bicarbonate Injection. Laboratory Test InteractionsAntinuclear antibodies may develop; usually reversible on discontinuation. May interfere with glucose or insulin tolerance test results. May cause changes in serum lipid levels. Adverse ReactionsCardiovascularHypotension; bradycardia; CHF; cold extremities; pallor; second or third-degree heart block. CNSInsomnia; fatigue; dizziness; depression; lethargy; drowsiness; forgetfulness. DermatologicRash; hives; fever; alopecia. EENTDry eyes; blurred vision; tinnitus; slurred speech; sore throat. GINausea; vomiting, diarrhea; dry mouth. GenitourinaryImpotence; painful, difficult, or frequent urination. HematologicAgranulocytosis; thrombocytopenia purpura. RespiratoryBronchospasm; shortness of breath; wheezing. MiscellaneousWeight changes; facial swelling; muscle weakness; inflammation at infusion site. PrecautionsPregnancyCategory C . LactationUndetermined. ChildrenSafety and efficacy not established. Renal FunctionReduced daily dose advised. Hepatic FunctionReduced daily dose advised. AnaphylaxisDeaths have occurred; aggressive therapy may be required. CHFAdminister drug in patients with CHF controlled by digitalis and diuretics. Notify health care provider at first sign or symptom of CHF or other unexplained respiratory symptoms. Diabetes mellitusMay mask signs and symptoms of hypoglycemia (eg, tachycardia, BP changes). May potentiate insulin-induced hypoglycemia. Nonallergic bronchospasm (eg, chronic bronchitis, emphysema)Use caution in patients with bronchospastic diseases. Peripheral vascular diseaseMay precipitate or aggravate symptoms of arterial insufficiency. ThyrotoxicosisMay mask clinical signs (eg, tachycardia) of developing or continuing hyperthyroidism. Abrupt withdrawal may exacerbate symptoms of hyperthyroidism, including thyroid storm. OverdosageSymptomsHypotension, bradycardia, intraventricular conduction disturbances, shock. Patient Information
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