[KnittingRN7]

I work in an outpatient cardiology clinic with a Ct scanner. We are currently using metoprolol for rate control. Some of the Dr's talked about trying esmolol because of the 9min 1/2 life. Another Dr said in other OP centers they use amiodarone. I would like to hear from anyone doing this and what their protocols are. I could imagine that their bloodpressure does not do well with these drugs and it would be more profound than metoprolol. Of course our pt population is 70% elderly with already compensated hearts and they are on a lot of oral meds. Any experiences?

[dianah]

Our Cardiologist uses IV Metoprolol (administered by him or one of our Fellows, as we RNs are busy in Stress Lab or Cath Lab).

Request literature from your MDs that supports what they want to do (use esmolol, etc) and discuss the options (eg, using esmolol w/elderly pts w/compensated hearts and many oral meds) as a group.
Then (as a collaborative effort, if possible) write strong protocols, based on the literature.

Sorry, I don't have much experience in this area, to comment more.
Good luck.

[Radnurse54]

We have some fellows and attendings who have been ordering esmolol for the Cardiac CTA patients, however, quite frankly I havent had any patients that it has been successful with. I think the po Lopressor works better than anything.
No emperical data, just my experience.