Brevibloc

Brevibloc

esmolol

Manufacturer:

Baxter Healthcare

Distributor:

Baxter Healthcare
/
Firma Chun Cheong
Concise Prescribing Info
Contents
Esmolol HCl
Indications/Uses
Rapid control of ventricular rate in patients w/ atrial fibrillation or atrial flutter in peri-op, post-op or other emergent circumstances where short-term control of ventricular rate w/ a short-acting agent is desirable. Non-compensatory sinus tachycardia where rapid heart rate requires specific intervention. Short-term treatment of tachycardia & HTN that occur during induction & tracheal intubation, during surgery, on emergence from anesth & in the post-op period.
Dosage/Direction for Use
Supraventricular tachycardia or non-compensatory sinus tachycardia Loading dose: 500 mcg/kg infused over 1 min, then maintenance of 50 mcg/kg/min for 4 min. If response is satisfactory, continue maintenance infusion. If response is unsatisfactory, give 2nd loading dose of 500 mcg/kg, followed by maintenance infusion of 100 mcg/kg/min for 4 min. If needed, procedure may be repeated 1-2 times (up to max of 3 loading doses), maintenance infusion may be increased by 50 mcg/kg/min each time (max: 200 mcg/kg/min). Maintenance infusion may be continued for up to 48 hr. Peri-op tachycardia or HTN: Immediate control 1 mg/kg bolus dose over 30 sec, then infusion of 150 mcg/kg/min if necessary. Adjust as required to a max of 200 (tachycardia) or 300 (HTN) mcg/kg/min. Gradual control 500 mcg/kg bolus dose over 1 min, then infusion of 50 mcg/kg/min for 4 min. Adjust as required to a max of 200 (tachycardia) or 300 (HTN) mcg/kg/min.
Contraindications
Hypersensitivity. Severe sinus bradycardia; heart block >1st degree; sick sinus syndrome; decompensated heart failure; cardiogenic shock; pulmonary HTN. IV administration of cardiodepressant Ca channel antagonists (eg, verapamil) & Brevibloc in close proximity.
Special Precautions
Hypotension; bradycardia including sinus pause, heart block, severe bradycardia & cardiac arrest; depression of myocardial contractility & precipitation of heart failure & cardiogenic shock; infusion reactions; hyperkalemia. Patients w/ reactive airways disease; hypoglycemia or DM; Prinzmetal's angina; pheochromocytoma; hypovolemia; peripheral circulatory disorders; metabolic acidosis; hyperthyroidism; patients at risk of severe acute hypersensitivity reactions. Closely monitor vital signs & titrate slowly in the treatment of patients whose BP is primarily driven by vasoconstriction associated w/ hypothermia. Observe patients for signs of myocardial ischemia when discontinuing inj. Pregnancy & lactation. Childn.
Adverse Reactions
Hypotension; infusion site reactions eg, inflammation & induration; nausea; dizziness, somnolence.
Drug Interactions
Increased blood levels of digoxin. Increased risk of bradycardia w/ digitalis glycosides. Prolonged neuromuscular blockade of succinylcholine. Increased risk of clonidine-, guanfacine-, or moxonidine-withdrawal rebound HTN. Risk of fatal cardiac arrests w/ cardiodepressant Ca channel antagonists. Counteracted effects w/ sympathomimetics. Risk of reducing cardiac contractility in presence of high systemic vascular resistance w/ vasoconstrictors & positive inotropes eg, epinephrine, norepinephrine, dopamine.
MIMS Class
Beta-Blockers
ATC Classification
C07AB09 - esmolol ; Belongs to the class of selective beta-blocking agents. Used in the treatment of cardiovascular diseases.
Presentation/Packing
Form
Brevibloc inj 10 mg/mL
Packing/Price
10 mL x 25 × 1's
Form
Brevibloc premixed inj 10 mg/mL
Packing/Price
250 mL x 1's
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