Which medications in the drug class Beta-Blockers, Beta-1 Selective; Antidysrhythmics, II are used in the treatment of Unstable Angina?

Updated: Oct 01, 2020
  • Author: Walter Tan, MD, MS; Chief Editor: Eric H Yang, MD  more...
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Beta-Blockers, Beta-1 Selective; Antidysrhythmics, II

Esmolol acts as a beta-adrenergic blocking agent to limit heart rate and reduces blood pressure by selectively targeting beta1 receptor sites; this drug also has class II antiarrhythmic properties. All beta-adrenergic blocking agents decrease myocardial oxygen demand and oppose the effects of elevated catecholamines. Infrequent situations in which beta-blocker therapy should be avoided in patients with unstable angina include nonischemic exacerbation of heart failure, cocaine-induced coronary vasoconstriction, and vasospastic angina.

Esmolol (Brevibloc)

Esmolol has been shown to reduce episodes of chest pain and clinical cardiac events. Its very short half-life (8 minutes) allows a large degree of dosing flexibility, so that its cardiovascular benefits are comparable to those of oral propranolol, yet its adverse effects can be managed promptly. Esmolol is particularly useful for patients at risk for complications with beta blockade (eg, reactive airway disease or chronic obstructive pulmonary disease [COPD], severe bradycardia, or poor left ventricular function).

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