Haemodynamic Control - Resources

 

Haemodynamic Control - Product Information

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PRODUCT INFORMATION AVAILABLE AT WWW.PHEBRA.COM. BREVIBLOC® (Esmolol Hydrochloride) Injection, Minimum Product Information. Indications: Supraventricular Tachycardia — for the rapid control of ventricular rate in patients with atrial fibrillation or atrial flutter in peri-operative, post-operative, or other emergent circumstances where short term control of ventricular rate is desirable. Non compensatory sinus tachycardia where, in the physician's judgement, the rapid heart rate requires specific intervention. BREVIBLOC® is not intended for use in chronic settings where transfer to another agent is anticipated or for treatment periods greater than 24 hours duration. Contraindications: Sinus bradycardia, heart block greater than first degree, cardiogenic shock or overt heart failure. In patients who require inotropic agents and/or vasopressors to maintain systemic blood pressure and cardiac output. The use of intravenous calcium channel antagonist agents with a beta-blocker may cause severe depression of myocardial function. Do not administer concomitantly with intravenous verapamil or within close proximity since fatal cardiac arrest has occurred. Precautions: Hypotension: Monitor BP if pre-treatment blood pressure is low, maintenance doses beyond 200 microgram/kg/min are not recommended. Cardiac Failure: Beta blockade may depress myocardial contractility and precipitate more severe failure. At the first sign or symptom of impending cardiac failure BREVIBLOC® should be withdrawn. BREVIBLOC® use should be undertaken with caution when the patient is haemodynamically compromised or is taking drugs that decrease peripheral resistance, myocardial filling, myocardial contractility, or electrical impulse propagation in the myocardium. Anaphylactic Reaction: Patients with a history of severe anaphylactic reaction may be more reactive to repeated challenge when administered beta-blockers. Bronchospastic Diseases: Patients with bronchospastic diseases should, in general, not receive beta-blockers. Diabetes Mellitus and Hypoglycaemia: Use BREVIBLOC® with caution. Impaired Renal Function: Administer BREVIBLOC® with caution. Pregnancy: (Category C). Lactation: Exercise caution. Use in Children: The safety and effectiveness of use has not been established. Adverse Effects: Deaths have been reported during complex clinical states. Very Common (≥10%): symptomatic hypotension (diaphoresis, dizziness), asymptomatic hypotension. Common (≥1 to <10%): peripheral ischaemia, dizziness, somnolence, confusion, headache, agitation, fatigue, nausea, vomiting, infusion site reaction (including inflammation & induration). Interactions with other drugs: Verapamil. Inotropic and vasoconstrictive compounds such as dopamine, adrenaline and noradrenaline. Catecholamine-depleting drugs. Digoxin. Intravenous morphine. Dosage and Administration: Supraventricular Tachycardia: responses to BREVIBLOC® usually occur within the range of 50 to 200 microgram/kg/min. The average effective dosage is approximately 100 microgram/kg/min, although dosages as low as 25 microgram/kg/min have been adequate in some patients. Dosage of BREVIBLOC® in supraventricular tachycardia must be individualised by titration. To initiate treatment, administer a loading infusion of 500 microgram/kg/min over one minute followed by a maintenance infusion of 50 microgram/kg/min. If an adequate effect is observed over the period of administration, maintain the infusion dosage with adjustments as needed. If an adequate effect is not observed, repeat the loading dose infusion over one minute and increase the maintenance infusion to 100 microgram/kg/min. Continue titration procedure, repeating the original loading dose of 500 microgram/kg/min over 1 minute and further increasing the maintenance infusion rate over the subsequent 4 minutes by 50 microgram/kg/min increments. As the desired heart rate or blood pressure is approached, reduce the infusion rate downward as appropriate. If desired, increase the interval between steps from five to ten minutes. Caution should be used in abruptly discontinuing infusions of BREVIBLOC® in coronary artery disease patients. Presentation: BREVIBLOC® Injection 100mg is supplied in 10mL vials in a pack of 5.

 

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