vi medicine informatics




Q: administer metoprolol or esmolol for the SVT & why? Esmolol FIRST because it has a half-life of 9 minutes and is also used in hypertensive emergencies. The ultra-short half-life of esmolol makes it an impractical choice for long-term treatment for this patient’s atrial flutter. However, esmolol serves an important role as trial therapy to ensure that the patient can tolerate β-blocker therapy (if the patient becomes hemodynamically unstable, the effects of esmolol will wear off within minutes.) An esmolol trial is particulary important in patients with comorbid cardiac conditions, such as myocardial infarction or congestive heart failure. If this patient tolerates the esmolol trial, it is safe to start him on a cardioselective β-blocker with a longer half-life.

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