Labetalol

Question 1

Labetalol- Name

Answer 1

Normodyne

Trandate

Question 2

Labetalol- Class

Answer 2

Alpha and Beta Adrenergic Blocking Agent

Question 3

Labetalol- MoA

Answer 3

Combines selective alpha and non selective beta adrenergic blocking actions. Both activities serve to reduce blood pressure.

1. Alpha Blockade leads to: vasodilation, decreased peripheral resistance, and orthostatic hypotension.
2. Beta Blockade leads to: effects on SA, AV nodes, and ventricular muscle that leads to bradycardia, delay in AV conduction and depression of cardiac contractility.

Question 4

Labetalol- Indications

Answer 4

Alone or in combination with other drugs to control Hypertension

Hypertensive Emergencies

Question 5

Labetalol- Contra

Answer 5

23BBCC

2nd or 3rd degree heart block

bradycardia

bronchial asthma

Cardiogenic shock

cardiac failure

Question 6

Labetalol- S/E

Answer 6

Cardiovascular: postural hypotension, angina, palpitations, bradycardia, syncope, CHF

CNS: Dizziness, vertigo, numbness, somnolence, Tingling of the scalp or skin

Respiratory: Dyspnea, bronchospasm

Miscellaneous: flushing, sweating,

Question 7

Labetalol- Routes

Answer 7

IVPB, IV, IO (can also be seen in PO form for home medication)

Question 8

Labetalol- A. Dose

Answer 8

20 mg slow IV push

with 40-80 mg every 10 minutes,

to a max dose of 300 mg total

OR

2 mg/min continuous IVPB,

to a total max dose of 300 mg

Question 9

Labetalol- P. Dose

Answer 9

Safety in children has not been established – not recommended.

Question 10

Labetalol- EXTRAS

Answer 10

Precautions: Use with caution during lactation, in impaired renal or hepatic function, in chronic bronchitis and emphysema, and in diabetes (may block signs of hypoglycemia), efficacy and safety in children has not been established.

Interactions:

beta-adrenergic bronchodilators ( i.e. Albuterol) – Labetalol decreases the bronchodilator effect of these drugs

Cimetidine (i.e. Tagamet): increases circulating labetalol levels

Tricyclic Antidepressants (i.e. Elavil, Tofranil) – increased risk of tremors

Do NOT use with IV calcium channel blockers.

Onset and Duration of Action: PO: 2-4 hrs, peak at 2-4 hrs, lasting 8-12 hours. IV: 5 minutes, lasting 90 minutes to 4 hours.

Notes: Monitor patient position changes, especially ambulating and upright positions, as labetalol often causes postural hypotension.