#建議持續輸注 (IV pump) 之高警訊藥品

高血壓 (Beta-blocker)
Intraoperative and postoperative tachycardia and/or hypertension
Sinus tachycardia: Treatment of noncompensatory sinus tachycardia
Supraventricular tachycardia and atrial fibrillation/flutter: Control of ventricular rate in patients with supraventricular tachycardia or atrial fibrillation/flutter

Antiarrhythmic Agent, Class II; Beta-1 Selective Blocker
Esmolol hydrochloride, a short-acting cardioselective adrenergic receptor blocker, exerts selective inhibitory effects on beta(1) receptors primarily found in the myocardium. At higher doses, it inhibits beta-2 receptors located in the musculature of the bronchi and blood vessels.

1. Distribution (Protein binding): 55%
2. Excretion (Renal): 73% to 88% as acid metabolite, less than 2% unchanged
3. Elimination Half Life: approximately 9 min

1. Cardiogenic shock
2. Decompensated heart failure; Second- or third-degree atrioventricular block; Severe sinus bradycardia 3. Hypersensitivity reactions (eg, anaphylaxis) to esmolol or any component of the product (possibility of cross sensitivity between beta blockers)
4. IV administration of cardiodepressant calcium-channel antagonists (eg, verapamil) in close proximity to esmolol hydrochloride (ie, while cardiac effects are still present)
5. Pulmonary hypertension
6. Sick sinus syndrome

C (FDA) (AUS)

Infant risk cannot be ruled out.(MDX)

Common: Hypotension, Injection site reaction, Nausea
Serious: Myocardial infarction, Seizure, Bronchospasm

Acute myocardial infarction:
1. Loading dose: 500 mcg/kg IV bolus over 1 minute; repeat bolus before each sequential step-up in infusion rate
2. Maintenance dose: sequential step-up in infusion rates 50, 100, 150, 200, 250, and 300 mcg/kg/min over 4 minutes
Hypertension, Intraoperative or Postoperative:
Immediate control:
1 mg/kg IV bolus over 30 seconds followed by 150 mcg/kg/min IV infusion if necessary; adjust infusion rate based on heart rate and blood pressure up to 300 mcg/kg/min
Gradual control:
1. Loading dose: 500 mcg/kg IV bolus over 1 minute followed by 50 mcg/kg/min IV infusion
2. Maintenance dose: sequentially increase infusion rate to 100, 150, and 200 mcg/kg/min every 4 minutes based on ventricular response; doses of 250 to 300 mcg/kg/min may be required
Rapid sequence intubation, Preinduction:
2 mg/kg IV given 1.5 to 3 minutes prior to intubation
Supraventricular tachycardia:
1. Loading dose: 500 mcg/kg IV bolus over 1 minute, followed by 50 mcg/kg/min IV infusion
2. Maintenance dose: sequentially increase infusion rate to 100, 150, and 200 mcg/kg/min every 4 minutes based on ventricular response; MAX 200 mcg/kg/min; administer for up to 48 hours
Tachycardia, Intraoperative or Postoperative:
Immediate control:
1 mg/kg IV bolus over 30 seconds followed by 150 mcg/kg/min IV infusion if necessary; MAX 200 mcg/kg/min
Gradual control:
1. Loading dose: 500 mcg/kg IV bolus over 1 minute followed by 50 mcg/kg/min IV infusion
2. Maintenance dose: sequentially increase infusion rate to 100, 150, and 200 mcg/kg/min every 4 minutes based on ventricular response; MAX 200 mcg/kg/min
Thyroid storm:
50 to 100 mcg/kg/min IV via pump

safety and effectiveness not established in pediatric patients.

CrCl <50 mL/minute: No dosage adjustment necessary when single or infrequent bolus doses are used for short interventional procedures.

No special precautions are necessary.