Betrixaban Maleate and Esmolol Hydrochloride

• Generic Name: betrixaban
• Dosage Forms: n.a.
• Other Brand Names: Bevyxxa

Prevention of venous thromboembolism in patients hospitalized for an acute medical illness who are at risk for thromboembolic complications due to moderately or severely restricted mobility and other risk factors for venous thromboembolism.

Pharmacologic thromboprophylaxis generally recommended in patients considered to be at high risk of venous thromboembolism. Anticoagulant prophylaxis recommended by ACCP in acutely ill, hospitalized medical patients at increased risk of thrombosis who are not actively bleeding and do not have an increased risk of bleeding. Such prophylaxis generally continued for 6–21 days until full mobility is restored or hospital discharge, whichever comes first; extended prophylaxis beyond these periods generally not recommended because of data suggesting unfavorable benefit-to-risk ratio for bleeding.

However, available data suggest benefit for extended-duration (35–42 days) betrixaban compared with standard-duration (6–14 days) enoxaparin for reducing risk of venous thromboembolism in hospitalized patients with acute medical illness and reduced mobility, at the cost of an increase in nonmajor but not major bleeding.

Safety and efficacy of betrixaban not established in patients with prosthetic heart valves.

• Generic Name: esmolol
• Dosage Forms: n.a.
• Other Brand Names: Brevibloc

Rapid, temporary control of ventricular rate in patients with supraventricular tachycardia (SVT) (e.g., atrial flutter and/or fibrillation, sinus tachycardia, junctional tachycardia, atrial tachycardia).

Vagal maneuvers and/or IV adenosine are considered first-line interventions for acute treatment of SVT when clinically indicated; if such measures are ineffective or not feasible, may consider an IV β-adrenergic blocking agent. Although evidence of efficacy is limited, experts state that overall safety of β-blockers warrants use.

May be used in patients with nonpreexcited atrial flutter and/or fibrillation to control rapid heart rate associated with surgical or other manipulative procedures (e.g., cardiac catheterization), or other emergent situations requiring short-term control of ventricular rate.

May be useful in patients with noncompensatory sinus tachycardia for short-term control of rapid heart rate requiring intervention.

Not intended for chronic use when other more appropriate antiarrhythmic agents would be preferred.

Treatment of intraoperative and postoperative hypertension and/or tachycardia. Has been used effectively for prevention or treatment of increases in BP associated with surgical events. However, use for prevention of such events is not recommended by the manufacturer.

Management of hypertensive emergencies in adults.

Rapid reduction of BP in the management of acute severe hypertension in pediatric patients with life-threatening symptoms.

Treatment to produce controlled hypotension during anesthesia in order to reduce bleeding resulting from surgical procedures (e.g., orthopedic surgery, neurosurgery).

Has been used for the management of acute tachyarrhythmias complicating acute MI and to minimize myocardial ischemia following acute MI or associated with unstable angina.

While current expert guidelines recommend an oral β-blocker in all patients with MI who do not have manifestations of heart failure, evidence of low-output state, increased risk of cardiogenic shock, or any other contraindications to β-blocker therapy, use of IV β-blockers should be limited to patients with refractory hypertension or ongoing ischemia.