An Enantiomerically Pure Formulation of Esmolol Attenuates Hypotension and Preserves Heart Rate Control in Dogs

McKee, Jeff; Rabinow, Barrett; Daller, Justin; Brooks, Benjamin D.; Baumgartner, Bernhard; Rohatgi, Priyanka

doi:10.1097/aln.0000000000000408

Cited by 1 publication

(1 citation statement)

References 21 publications

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“…However, esmolol has important negative inotropic actions, because it is racemic of R- and S-enantiomers; the R-enantiomer is responsible for the negative inotropic effect and lowering of the blood pressure, whilst S-enantiomer is a pure rate lowering. 34 Esmolol efficacy is also blunted by tolerance and rebound phenomenon because of the up-regulation of the blocked receptor (chaperoning effect). 35 Landiolol is a relatively new rapid-acting beta-blocker surpassing some of the limitations of esmolol.…”

Section: Acute Heart Rate Controlmentioning

confidence: 99%

Acute rate control in atrial fibrillation: an urgent need for the clinician

Dan

Ivănescu

et al. 2022

European Heart Journal Supplements

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Rate and rhythm control are still considered equivalent strategies for symptom control using the Atrial Fibrillation Better Care algorithm recommended by the recent atrial fibrillation guideline. In acute situations or critically ill patients, a personalized approach should be used for rapid rhythm or rate control. Even though electrical cardioversion is generally indicated in haemodynamically unstable patients or for rapid effective rhythm control in critically ill patients, this is not always possible due to the high percentage of failure or relapses in such patients. Rate control remains the background therapy for all these patients, and often rapid rate control is mandatory. Short and rapid-onset-acting beta-blockers are the most suitable drugs for acute rate control. Esmolol was the classical example; however, landiolol a newer very selective beta-blocker, recently included in the European atrial fibrillation guideline, has a more favourable pharmacokinetic and pharmacodynamic profile with less haemodynamic interference and is better appropriate for critically ill patients.

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Section: Acute Heart Rate Controlmentioning

confidence: 99%