Pharmacology. Esmolol is a short-acting, IV, cardioselective beta-adrenergic blocker with no intrinsic sympathomimetic or membrane-depressant activity. In usual therapeutic doses, it causes little or no bronchospasm in patients with asthma. Esmolol produces peak effects within 6–10 minutes of administration of an intravenous bolus. It is hydrolyzed rapidly by red blood cell esterases, with an elimination half-life of 9 minutes; therapeutic and adverse effects disappear within 30 minutes after the infusion is discontinued.

Indications

1. 
   

   Rapid control of supraventricular and ventricular tachyarrhythmias and hypertension, especially if caused by excessive sympathomimetic activity (eg, stimulant drugs, hyperthyroid state).

   
   
2. 
   

   Reversal of hypotension and tachycardia caused by excessive beta-adrenergic activity resulting from theophylline or caffeine overdose.

   
   
3. 
   

   Control of ventricular tachyarrhythmias caused by excessive myocardial catecholamine sensitivity (eg, chloral hydrate and chlorinated hydrocarbon solvents).

Contraindications

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