Blood pressure and rate control
Esmolol (Brevibloc) drip
Brevibloc
Dosing
| Start | Load 500 mcg/kg over 1 minute, then 50 mcg/kg/min |
|---|---|
| Titrate | Re-load and raise by 50 mcg/kg/min every 4 minutes |
| Maximum | 200 mcg/kg/min for rate control; 300 for hypertension |
| Common bags | 2,500 mg in 250 mL (10 mg/mL); 2,000 mg in 100 mL (20 mg/mL) |
| Dose units | mcg/kg/min |
Line and administration
- Over 10 mg/mL irritates small veins: use a central line for 20 mg/mL
Watch for
- Bradycardia and hypotension
- Effects wear off within about 20 minutes of stopping
Esmolol: full drug monographIndications, mechanism, pharmacokinetics, cautions and every dose the app lists.
In the one-pagers
- Aortic Dissection and Hypertensive EmergencyAortic dissection: Beta-blocker FIRST (esmolol or labetalol), then a vasodilator (nicardipine, clevidipine or nitroprusside) if BP stays high
- Rhythm GalleryAtrial rhythms: PACs, MAT, flutter and AF: Esmolol: 500 mcg/kg over 1 min, then 50–200 mcg/kg/min: Hypotension; wears off within 20 min
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Other blood pressure and rate control
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For education and exam preparation only. Follow your institution’s protocols. Study aid: check every dose against your local protocols and medical direction, the bag label and your pump.