BREVIBLOC (ESMOLOL HCL)

Brevibloc Information

Brevibloc or otherwise known by its generic name Esmolol Hydrochloride is a cardioselective adrenergic receptor blocking agent. It has a very short duration of action.

Brevibloc Indications

Brevibloc is indicated for the rapid control of ventricular rate in patients. Patients with atrial flutter in periopertative or atrial fibrillation, postoperative, or in any other conditions where in a short-acting agent is enviable along a short term control of ventricular rate.

Brevibloc is in the other hand also indicated for treating hypertension and tachycardia that transpire during stimulation and tracheal intubations, surgery, surfacing from anesthesia, and in the postoperative period.

The use of Brevibloc to avoid such events is not suggested.

Brevibloc Warnings/Precautions

Absolute care should be taken when using Brevibloc. It has been reported that sloughing of the skin and necrosis may happen.

Nursing women

For nursing women, it is not known as to whether Brevibloc is excreted in mother’s breast milk but it is best to take maximum caution when administering Brevibloc to nursing women.

Pregnant women

For pregnant women, a study has been conducted on rats for evidence of maternal toxicity and embryotoxicity or teratogenicity at certain dosages of Brevibloc. With 3000 mcg/kg/min no evidence was found. However, at 10,000 mcg/kg/min evidence of maternal toxicity and lethality where found. Although there has been no tests conducted on human patients, there were recorded reports of fetal bradycardia due to the use of Brevibloc upon delivery or labor or the last trimester of pregnancy.

Pediatric patients

Effectiveness and safety of Brevibloc to pediatric patients has not been tested or established.

Brevibloc Medicine Intake Guidelines

There are many different ways of using Brevibloc among these are use of premixed bag, Injection ready to use vial, use of Brevibloc Concentrate. It is recommended that you consult your doctor or ask your pharmacist for the directions of using Brevibloc.

Brevibloc Dosage

Use ventricular rate as guide. Initial dose is 0.5 milligrams/kg over a minute duration and 0.05 milligrams/kg for the next dose for the next 4 minutes is recommended.

Depending upon the desired ventricular response the maintenance infusion may be continued after the minutes of initial maintenance infusion, it may be continued with 0.05 mg/kg/min or increment step-wise (e.g. 0.1 mg/kg/min, 0.15 mg/kg/min, maximum of 0.2 mg/kg/min) and maintain each step with 4 or more minutes.

Brevibloc Overdose

Cardiac arrest is most likely to happen on the event of Brevibloc overdose. In addition, a few more may be experienced, bradycardia; hypotension; electromechanical dissociation and loss of consciousness.

Be very careful on diluting Brevibloc as to most cases of overdose happen on dilution errors. However, to avoid such errors the use of Brevibloc premixed injection and Brevibloc double premixed injection is recommended.

Brevibloc Missed Dose

Never take double doses of Brevibloc even if you have missed a dose. If you happen to miss a dose, you can make up for it only if it is not yet time for the next scheduled dose. However, it is already near the time for the next dose, entirely skip the dose you missed and proceed with the next scheduled one.

Brevibloc Side Effects

The side effects mentioned bellow is based on the use of Brevibloc in clinical trials.

Cardiovascular

Symptomatic hypotension
Asymptomatic hypotension
Diaphoresis with hypotension
Peripheral ischemia

Central nervous system

Dizziness
Somnolence
Confusion
Headache
Agitation

Respiratory

Bronchospasm
Wheezing
Dyspnea
Nasal congestion
Rhonchi
Rales

Brevibloc

Drug Reactions

Catecholamine-depleting drugs, such as reserpine, may have a stabilizer effect when given with beta blocking agents. Patients treated along with Brevibloc and a catecholamine depletor should be monitored for evidence of hypotension or marked bradycardia, which may result in vertigo, syncope, or postural hypotension.