Beta-Antagonists

Question 1

Esmolol: Class

Answer 1

Selective Beta1 antagonist

Question 2

Esmolol: Use

Answer 2

To prevent or minimize tachycardia or HTN from perioperative stimuli (Intubation, Surgical Stimulation, Emergence)

Question 3

Esmolol: Mechanism of Action

Answer 3

Competitive antagonist of Beta1 receptors

Question 4

Esmolol: Dose

Answer 4

Bolus: 0.5mg/kg or 10mg

Infusion: 50 mcg/kg/min
Can titrate q 5minutes to max dose 200mcg/kg/min

Question 5

Esmolol: Pharmacokinetics

Answer 5

Absorption: IV

Onset: 1 minute
Duration of Action: 5 minutes

Metabolism: Rapid Hydrolysis by plasma esterase in RBCs

Elimination: Renal

Question 6

Esmolol: Contraindications

Answer 6

Patients with:
Bradycardia
Hypotension
CHF
Bronchoconstriction

Question 7

Esmolol: Considerations

Answer 7

Administration intra-operatively can help reduce the use of post-operative opioids

Question 8

Labetalol: Class

Answer 8

Non-selective beta antagonist

Question 9

Labetalol: Use

Answer 9

Used to treat Tachycardia and HTN

Question 10

Labetalol: Mechanism of Action

Answer 10

Competitive antagonist of Beta1, Beta2, and Alpha1 receptors
Beta blockade to Alpha Blockade = 7:1

Question 11

Labetalol: Dose

Answer 11

Bolus: 5 - 20 mg

Question 12

Labetalol: Pharmacokinetics

Answer 12

Absorption: IV

Onset: 5 minutes
Duration of Action: 3 hours

Metabolism: Hepatic

Elimination: Hepatic and Renal

Question 13

Labetalol: Contraindictions

Answer 13

Patients with:
Bradycardia
Hypotension
CHF
Asthma
COPD

Question 14

Labetalol: Considerations

Answer 14

May cause:
LV failure
Orthostatic hypotension
Bronchospasm