Esmolol
Also known as: Brevibloc, Miniblock
Esmolol is an emergency, ultra-short-acting medication administered exclusively in a veterinary hospital setting. * **Continuous Monitoring:** Your pet will be closely monitored with an ECG (electrocardiogram) and blood pressure equipment while receiving this medication. * **Purpose:** It is often used to rapidly stabilize dangerous heart rhythms or as a "test run" to see if your pet's heart condition will respond well to longer-acting oral beta-blockers. * **Safety:** Because it clears from the bloodstream in minutes, any side effects (like low blood pressure or a slow heart rate) typically resolve very quickly once the infusion is stopped.
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
What it is used for
- HCM (to determine if beta-blockers will reduce dynamic left-ventricular outflow tract obstruction)
- Critical Arrhythmias
- Ultra-short acting beta blockade (ventricular arrhythmias) - Normal cardiac function
- Ultra-short acting beta blockade - Severe dilated cardiomyopathy or severe mitral regurgitation
- SVTs
- Arrhythmia conversion
How it is given
Possible side effects
- Hypotension
- Bradycardia
- Heart block
- Exacerbation of congestive heart failure
- Bronchospasm (at high doses where beta-1 selectivity is lost)
Cautions & contraindications
- Overt cardiac failure
- 2nd or 3rd degree AV block
- Sinus bradycardia
- Cardiogenic shock
- Second or third-degree AV block
- Uncompensated congestive heart failure
- Hypotension
- Use with caution (weigh benefit vs. risk) in patients with congestive heart failure (CHF), bronchoconstrictive lung disease, or diabetes mellitus. Esmolol may mask certain clinical signs of developing hypoglycemia (such as increased heart rate or blood pressure).
Drug interactions
- Digoxin: Esmolol may increase serum digoxin levels up to 20%, but these drugs have been used together safely and effectively.
- Monoamine Oxidase Inhibitors (MAOIs): Concurrent use is not recommended due to potential risk of hypertension.
- Morphine: May increase steady-state esmolol serum concentrations up to 50%; titrate esmolol dosage carefully.
- Reserpine: May see additive effects (hypotension, bradycardia) if used with esmolol.
- Vasoconstrictors/Inotropes (e.g., dopamine, epinephrine, norepinephrine): If systemic vascular resistance is high, there is an increased risk for blocked cardiac contractility; esmolol is not recommended to control SVTs in patients receiving these drugs.
- Verapamil: In humans, particularly with severe cardiomyopathy, cardiac arrest has occurred (rarely).
- Calcium channel blockers (e.g., Diltiazem, Verapamil): Additive negative inotropic and chronotropic effects; risk of severe bradycardia and hypotension
- Alpha-2 agonists (e.g., Dexmedetomidine): Increased risk of severe bradycardia
- Sympathomimetics (e.g., Epinephrine): Mutual antagonism
Frequently asked questions
What is Esmolol used for in pets?
Esmolol is an emergency, ultra-short-acting medication administered exclusively in a veterinary hospital setting. * **Continuous Monitoring:** Your pet will be closely monitored with an ECG (electrocardiogram) and blood pressure equipment while receiving this medication. * **Purpose:** It is often used to rapidly stabilize dangerous heart rhythms or as a "test run" to see if your pet's heart condition will respond well to longer-acting oral beta-blockers. * **Safety:** Because it clears from the bloodstream in minutes, any side effects (like low blood pressure or a slow heart rate) typically resolve very quickly once the infusion is stopped.
Is Esmolol safe for my pet?
Dosage must be set by your veterinarian for your specific pet. Never give human medication or another pet’s prescription without veterinary guidance.
This article is for general education and is not a substitute for professional veterinary advice. If your pet is unwell, please consult a veterinarian.
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