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Esmolol [ess' moe lol]
(Class II, Beta-Adrenergic Receptor Blocker)

  •  Esmolol is a very short acting, cardioselective beta-adrenergic receptor antagonist.

  •  i.v. administration is used for rapid beta-receptor blockade in treatment of atrial fibrillation with high ventricular following rates.

  •  Antiarrhythmic effects are due mainly to beta-adrenergic receptor blockade. Normally, sympathetic drive results in increased in Ca2+ ,K+and Cl- currents.

  •  Increased sympathetic tone also increases phase 4 depolarization (heart rate goes up), and increases DAD (delayed afterdepolarizations) and EAD (early afterdepolarization) mediated arrhythmias.

    • These effects are blocked by beta-adrenergic receptor blockers.

  • Beta-adrenergic receptor blockers increase AV conduction time and increase AV nodal refractoriness, thereby helping to terminate nodal reentrant arrhythmias.


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