Int J Clin Pharm Th
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Int J Clin Pharm Th · Apr 1995
ReviewClinical rationale for the use of an ultra-short acting beta-blocker: esmolol.
Esmolol is a unique cardioselective, intravenous, ultra-short acting, beta-adrenergic blocking agent. A 9-minute half-life with rapid clinical onset and offset of action and the ability to titrate the drug to changing circumstances makes esmolol a useful addition to our treatment armamentarium. The efficacy and safety of esmolol have been shown in specific clinical settings, i.e. in patients with unstable angina, myocardial infarction, atrial fibrillation or flutter and supraventricular tachycardia. ⋯ The most frequently reported adverse effect associated with esmolol infusion was hypotension. Adverse effects due to beta-blockade can be corrected by down-titrating or discontinuing the infusion with complete disappearance of clinical effects in 20-30 minutes. Therefore, as an ultra-short acting beta-blocker, esmolol is an important therapeutic option in the acute clinical setting.
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Cocaine abuse today is widespread and is on the increase in North America. It is estimated that one in every four Americans has used cocaine for its euphorigenic properties. With increasing participation of younger age subjects in the cocaine abuse, the effects of cocaine on the reproductive system have attracted considerable attention. ⋯ Additionally, since cocaine is freely excreted in the milk, its effects on nursing have raised serious concerns. In this review, the effects of cocaine on various elements of reproduction, namely endocrines, fertility, libido, intercourse, pregnancy, fetal development, childbirth, neonates and infants have been analyzed systematically. It is believed that a clearer understanding of the cocaine's effects on various aspects of reproduction is essential to counsel and treat the pregnant women and to protect the newborn.