ตารางแสดงการเปรียบเทียบยากลุ่ม Beta-blocker ที่ให้ทางหลอดเลือดดำ
Agent
|
FDA-Approved Indication(s) for
Intravenous Administration*
|
Intravenous
Dose Recommendations (Adult)
|
Comments
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Atenolol
(Tenormin®)
|
- Acute myocardial infarction
|
5 mg IV
bolus over 5 minutes, followed by a second IV bolus 10 minutes later
|
§
Beta-1 selective
§ Maximum IV bolus dose = 10 mg
|
Esmolol
(Brevibloc®)
|
- Hypertension, intra-operative or
- Tachyarrhythmia, intra-operative
|
80 mg IV
bolus (» 1 mg/kg) over 30 seconds, generally followed by
continuous infusion
|
§
Beta-1 selective
§
Short-acting (t1/2 » 9
minutes)
§
May be used as a continuous infusion
§
When used for acute myocardial infarction, dosing is
generally the same as listed for supraventricular arrhythmia
§
Maximum continuous infusion rate = 200 mcg/kg/minuteจ
|
- Hypertension, post-operative or
- Tachyarrhythmia, post-operative
|
500 mcg/kg
IV bolus over 1 minute, generally followed by continuous infusion or oral
maintenance dose
| ||
- Supraventricular arrhythmia
|
500 mcg/kg
IV bolus over 1 minute, generally followed by continuous infusion or oral
maintenance dose
|
||
Labetalol
(Trandate®)
|
- Hypertension
|
20 mg IV
bolus over 2 minutes (may repeat injections of 20-80 mg at 10 minute
intervals)
Maximum
total dose = 300 mg
|
§
Nonselective beta-adrenergic blocker with selective alpha-adrenergic
blockade
§
May be used as a continuous infusion
|
Metoprolol
(Lopressor®)
|
- Acute myocardial infarction
|
5 mg IV
bolus every 2 minutes x 3 (total dose = 15 mg)
|
§
Beta-1 selective
§
May be used as a continuous infusion
|
- Cardiac dysrhythmia
|
2.5 - 5 mg
IV bolus over 2 minutes, may repeat to total of 3 doses (higher doses may be
necessary)
|
||
Propranolol
(Inderal®)
|
- Acute myocardial infarction
|
0.1 mg/kg
divided into 3 equal doses given at 2-3 minute intervals (rate not to exceed
1 mg/min)
|
§
Nonselective beta-adrenergic blocker
§
Administration rate should not exceed 1 mg/minute
§
Initial dose may be repeated in 2 minutes, but additional
doses should not be administered until 4 hours later
§
Most references suggest continuous EKG monitoring when IV
propranolol is administered
|
- Cardiac dysrhythmia
|
0.5 -
3 mg IV bolus
(rate not
to exceed 1 mg/min)
Or
0.1 mg/kg
divided into 3 equal doses given at 2-3 minute intervals
|
||
- Thyroid storm, rapid control
|
1 mg/min
IV bolus (maximum dose = 10 mg). May
repeat in 4 - 6 hours
|
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