Esmolol drip is a cardiovascular system medicine used in the treatment of Supraventricular, tachycardia, perioperative tachycardia and hypertension. It is rapid Acting Blood Pressure Medicine

Esmolol hcl is a beta 1-selective (cardioselective) adrenergic receptor blocking agent available under brand name of Brevibloc. It can rapidly control ventricular rate.

The normal dosage is 500 mcg/kg/min for 1 min, in case of Perioptachy-1000 meg/kg within 30 sees. Maintenance – for SVT & perioptachycardia: Initiate with 50 mcg/kg/min for 4 mins increasing maximum up to 300 mcg/kg/min. Every increment of 50 meg/ kg/min in maintenance should be preceded by the same loading dose.

Contra indication of Esmolol includes sinus bradycardia, heart block, cardiogenic shock or overt heart failure. Special precaution has to be taken for use in pregnancy, nursing mothers, and in children. Side effects of esmolol include hypotension, dizziness, headache, confusion, fatigue, paresthesia, asthenia, depression, anxiety, anorexia and bronchospasm. No significant drug interaction is seen with with digoxin, warfarin and morphine.

DIGOXIN is a CARDIAC  GLYCOSIDES type of drug. It has direct effects on myocardial contractility and electrophysiological conduction properties i.e. 1. Negative chronotropic effect (Reduces heart rate & A.V. conduction). 2. Positive inotropic effect i.e. there is a dose dependent increase in force of contraction of myocardium. The above two effects thereby make it an ideal drug for treatment of cardiac failure of diverse aetiologies without increasing the oxygen demand of the failing myocardium. There is also a mild direct vasoconstrictor action thereby increasing peripheral resistance mildly. Diuresis is seen promptly in C.H.F. patients owing to improved renal perfusion which was previously compromised but at times an addition of diuretic may be considered to improve the patients hypoxic and hypervolemic condition rapidly if need arises.

DIGOXIN is used in Congestive heart failure, cardiac tachyarrhythmias (Paroxysmal supraventricular tachycardia, atrial flutter & fibrillation). Dosage : Initially 0.25-1.5 mg daily. Maint; 0.25-0.5 mg daily. For Children : initially 10-20 meg/kg body wt. 6 hrly. Maint 10-20 meg/kg body wt. in single or divided doses daily. 

Contra-lndicatlons of DIGOXIN : Hypokalemia, ventricular tachycardia, partial A.V.    block, acute myocarditis. Wolf-Parkinson-White Syndrome. Special Precautions has to be taken in Elderly, renal or severe hepatic disease, myocardial infarction and  thyrotoxi-cosis patients.

Common Side-effects that can be expected with DIGOXIN are Anorexia, nausea, vomiting, ab¬dominal pain, fatigue, headache, mental confusion, restlessness.

PROPRANOLOL is a BETA  BLOCKERS group of medicines for heart ailments. It decreases heart rate, force of contraction & cardiac output. On prolonged administration BP gradually falls in hypertensives but not in normotensives.

PROPRANOLOL is used in Hypertension, angina pectoris, cardiac arrhythmias, post M.I. tachycardia,migraine and anxiety. the common  Dosage is 10 mg B.D. to 160 mg Q.I.D (average 40-160 mg/day)

Contra-lndicatlons of PROPRANOLOL are Obstructive COPD like asthma. Partial or complete heart block, C.H.F. Acute M.I. Cardiogenic shock and those taking Digitalis & verapamil therapy.

Special Precautions have to be taken while taking PROPRANOLOL in Impaired renal & hepatic functions, pregnancy, cardiac failure. Myocardial insufficiency and  reduced cardiac reserve. Side-effects include Tiredness, lack of drive, G.I. upsets, nightmares, forgetfulness, rare cases of  hallucinations, muscle fatigue.

PROPRANOLOL can interact with other drugs and can cause Hypertension & bradycardia with adrenaline, reduced heart rate & output with anaesthetic agents. Also Severe bradycardia may occur with digitalis and calcium channel blockers. PROPRANOLOL causes elevated blood levels with cimetidine .

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