Esomolol Hydrochloride injection I.P.

Description – Esmoage 10ml Inj. Is available in liquid form

10mg per ml inj

Indication –

Supraventricular Tachycardia

Perioperative Tachycardia and Hypertension

Dosage

1. Optional loading dose (500mcg/kg IV over 1 minute), then 50mcg/kg/min IV for 4 minutes; If the response is adequate, the infusion may be maintained at 50mcg/kg/min; if the response is inadequate, see Step 2
2. Optional loading dose (500mcg/kg IV over 1 minute) if necessary, then 100mcg/kg/min IV for 4 minutes; If the response is adequate, the infusion may be maintained at 100mcg/kg/min; If the response is inadequate, see Step 3
3. Optional loading dose (500mcg/kg IV over 1 minute) if necessary, then 150mcg/kg/min IV for 4 minutes; if the response is adequate, the infusion may be maintained at 150mcg/kg/min; if the response is inadequate, see Step 4
4. Optional loading dose (500mcg/kg IV over 1 minute) if necessary, then 200mcg/kg/min IV for 4 minutes

Uses

1. To control rapid heartbeats or abnormal heart rhythms
2. Fast heartbeat and high blood pressure during surgery, after surgery or during other medical procedure

Contraindications

• Sinus Bradycardia
• Atrioventricular heart block
• Heart failure
• Cardiogenic shock
• Pulmonary Hypertension

Special Precautions

• Bradycardia
• Heart block

Adverse Drug Reaction

• Allergic Reaction - Skin rash, itching, hives, swelling of the face, lips, tongue or throat
• Heart failure – shortness of breath, swelling of the ankles, feet, or hands, sudden weight gain, unusual weakness and fatigue
• High potassium level – muscle weakness, fast or irregular heartbeat
• Low blood pressure – dizziness, feeling faint or lightheaded, blurry vision
• Slow heartbeat – dizziness, feeling faint or lightheaded, confusion, trouble breathing, and unusual weakness or fatigue

Drug Interaction

• Digoxin
• Mivacurium
• Succinylcholine
• Certain medications for blood pressure, heart disease, irregular heartbeat

Mechanism of Action

        Esmolol is a short acting, cardio selective Beta blocker, a class II antiarrhythmic agent that is a competitive antagonist of the Beta 1 adrenergic receptors primarily in the myocytes.

        By blocking the adrenergic activity of epinephrine and norepinephrine, it decreases contractility (negative inotropic effect), heart rate (negative chronotropic effect) and conduction

        Esmolol increases Atrioventricular refractory time, decreases oxygen demand of the myocardium and decreases Atrioventricular conduction (negative dromotropic effect)

        A minor Beta II adrenergic blockade is reported with high IV infusion doses.

        Esmolol does not have any membrane stabilizing activity or alpha adrenergic blockade