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Evaluation of the efficiency and safety of Esmolol in patients, who suffers from hypertensic crisis, within the conditions of emergency medical care

https://doi.org/10.24884/2072-6716-2023-24-2-33-39

Abstract

   In 94 patients, suffering from complicated or uncomplicated hypertensic crisis, the efficiency and safety of esmolol administration in pre-hospital stage of emergency medical care was examined. Unique pharmacokinetics of esmolol allow us to achieve significant arterial tension decrease during the first minutes of the intravenous injection, meanwhile antihypertensive effect increases till 20 minutes and elimination half-life is 9 minutes. Esmolol dosage was selected depending on initial hemodynamic indicators and hypertensic crisis complications. In order to evaluate efficiency and safety in this research the following indicators were measured: sistolic blood pressure, diastolic blood pressure, heart rate, electrocardiogram and SpO2 , respiratory function monitoring.

About the Author

N. I. Gaponova
Moscow State University of Medicine and Dentistry; Еmergency Medical Care Station of A. S. Puchkov
Russian Federation

Nadezhda Ilinichna Gaponova

Moscow



References

1. Reschetnikov A. V. Medicine sociology: guideline. St. Petersburg: Publishing house GEOTAR­Media, 2010. 864 р. (In Russ.)

2. Nolan C. R. Hypertensive Crises // Schrier R. W., ed. Atlas of desease of the kidney. Vol. 3. Philadelphia: Current medicine, 1999.

3. Tereshchenko S. N., Plavunov N. F. Нypertensive crises. Moscow: Publishing house MEDpress inform Publishing house, 2011. 208 p. (In Russ.)

4. Guidelines for the diagnosis and treatment of non­ ST­segment elevation acute coronary syndromes. The Task Force for the Diagnosis and Treatment of Non­ ST­Segment Elevation Acute Coronary Syndromes of the European Society of Cardioogy // Eur. Heart J. 2007. Vol. 28. P. 1598–1660.

5. Frishman W., Jacob H., Eisenberg E. et al. Clinical pharmacology of the new beta­adrenergic blocking drugs. Part 8: self­poisoning with beta­adrenoceptor blocking agents: recognition and management // Am. Heart J. 1979. Vol. 98. P. 798–811.

6. Kirshenbaum J. M., Kloner R. F., Gowan N. et al. Use of an ultrashort­acting beta­receptor blocker (esmolol), in patients with acute myocardial ischemia and relative contraindications to beta­blockade therapy // J. Amer. Coll. Cardiol. 1988. Vol. 12. P. 773–780.

7. Schultz N. J., Tschida V. H., Arom K. V. et al. Antidysrhythmic efficacy and safety of esmolol: an ultra­ short acting cardioselective beta blocker Drug intel // Clin. Pharmacol. 1984. P. 18–496.

8. Schwartz M., Michelson E. L., Sawin H. S. et al. Efficacy and safety of esmolol for postoperative atrial fibrillation/flutter // Clin. Res. 1989. Vol. 5, No. 33. P. 748. 9. Shand D. G. Clinical pharmacology of the beta­blocing drugs: implication for the postifarction patient // Circulation. 1983. Vol. 67, Suppl. 1. P. 1–5.

9. Deegan R., Wood A. J. Beta­receptor antagonism ctoes not fully explain esmolol­induced hypotension // Clin. Pharmacol Ther. 1994, Vol. 56. P. 223–228.

10. Papademetriou V., Devereux R. B., Naravan P. et al. Similar effects of isolated systoic hypertenson on left ventricular geometry and function: the LIFE study // Am. J. Hypertens. 2001. Vol. 14, No. 8, Pt 1. P. 768–774.

11. Shalaev S. V. Beta­blockers in the treatment of acute coronary syndromes (or is it necessary to prove proven). Consilium Medicum, 2001, No. 3, pp. 469–472 (In Russ.)

12. Shalaev S. V., Bukhvalov V. A., Petrik E. S. The use of a beta­blocker esmolol in patients with acute myocardial infarction treated with streptokinase. Cardiology, 2002, Vol.

13. 42, No. 6, рр. 4–7 (In Russ.)

14. The Task Force on the management of acute myocardial infarction of theEuropean Society of Cardiology. Acute myocardial infarction: prehospital and in­hospital management // Eur. Heart J. 1996. Vol. 17. P. 43–63.

15. Management of acute coronary syndromes: acute coronary syndromes without persistent STsegment elevation. Recommendations of Task Force of the European Society of Cardiology // Eur. Heart J. 2000. Vol. 21. P. 1406–1432.

16. Tereschenko S. N. The place of short­ acting beta­adrenoblocker in the cardiologic practice. MKS, 2004, No. 1, рр. 13–20 (In Russ.)

17. Das G., Tschida V., Gray R. et al. Efficacy of esmolol in the treatment and transfer of patientswith supraventricular tachyarrhythmias to altemate oral antiarrhythmic agents // J. Clin. Pharmacol. 1988. Vol. 28. P. 746–750.


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For citations:


Gaponova N.I. Evaluation of the efficiency and safety of Esmolol in patients, who suffers from hypertensic crisis, within the conditions of emergency medical care. EMERGENCY MEDICAL CARE. 2023;24(2):33-39. (In Russ.) https://doi.org/10.24884/2072-6716-2023-24-2-33-39

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