Introduction

Class of drug

• Ultra short-acting beta blocker.

Uses

Indications

• Treatment of supraventicular tachycardia:
  • Atrial fibrillation Heart: dysrhythmia.
  • Atrial flutter.
  • Atrial tachycardia.

Administration

Precautions

Interactions

with other drugs

Sympathomimetics

• Beta effects of phenylpropanolamine Phenylpropanolamine / diphenylpyraline , epinephrine Epinephrine , and terbutaline Terbutaline may be blocked and unopposed alpha effects can → hypertension and bradycardia.

Anaesthetic agents, phenothiazines, antihypertensives, diazepam, diuretics and antiarrhythmics

• Enhance hypotensive effect.

Calcium channel blockers

• Diltiazem Diltiazem and verapamil Verapamil increase risk of bradycardia, severe hypotension, heart failure and AV block.

Digoxin

• Bradycardia increased by concurrent administration.

Thyroid hormones

• Enhance metabolism of esmolol thus reduce effect.
• Dose of esmolol should be decreased when initiating carbimazole Carbimazole therapy.

Cimetidine

• May decrease metabolism of esmolol.

Muscle relaxants

• Esmolol enhances effects of suxamethonium Suxamethonium , tubocurarine.

Phenobarbitone and phenytoin

• May increase rate of metabolism of esmolol by hepatic enzyme induction.

Lidocaine

• Reduces lidocaine Lidocaine clearance therefore increases risk of lidocaine toxicity.

Theophylline

• May block bronchodilatory effects of theophylline Theophylline.

Adverse Reactions

Further Reading

Publications

Refereed papers

• Recent references from PubMed and VetMedResource.

Other sources of information

• BSAVA Small Animal Formulary. Ramsey I (2017) 9th edn. Cheltenham: BSAVA.