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Although beta blockade is an important therapeutic tool, prolonged side effects limit its usefulness, particularly in short-term care. Esmolol, another step in the trend toward "custom-made" drugs, was synthesized with the above limitation in mind. It is a cardioselective, ultra-short-acting beta blocker that is rapidly metabolized by an esterase in the erythrocyte cytosol to an inactive metabolite. Its half-life is only nine minutes; therefore, one can minimize side effects simply by stopping infusion of the drug.
In preliminary clinical trials, esmolol has been found useful in reducing the heart rate of patients with supraventricular tachyarrhythmias and in limiting the oxygen requirements of patients with acute myocardial infarction and u…