β1 blocker (ultra-short)
Esmolol
Brevibloc Hypotensive — violet/white stripes 10 mg/mL
Titratable β1 blockade — great for laryngoscopy tachycardia.
Typical adult doses
| Indication | Dose | Onset | Duration |
|---|---|---|---|
| Bolus | 0.5 mg/kg IV (or 10–20 mg increments) | 1–2 min | ≈10 min |
| Infusion | 50–300 mcg/kg/min | — | — |
Mechanism
Cardioselective β1 antagonist metabolized by red-cell esterases (t½ ≈9 min).
Key effects
- ↓ HR, ↓ contractility
Watch out for
- Hypotension, bradycardia
Pimp questions
Pimp question
Why is esmolol so short-acting?
Answer
Rapid hydrolysis by red blood cell esterases.