Labetalol hydrochloride

Question 1

Generic name for Trandate?

Answer 1

labetalol hydrochloride

Question 2

Trade name for labetalol

Answer 2

Trandate

Question 3

Classification of labetalol

Answer 3

Alpha and beta adrenergic blocker; antihypertensive

Question 4

What is labetalol supplied in?

Answer 4

5mg/mL in 20, 40 and 60 mL vials

Question 5

Pharmacodynamics of labetalol

Answer 5

❑ Antihypertensive: Inhibits catecholamine access to both beta and postsynaptic alpha-adrenergic receptor sites. (May also have a vasodilating effect).

Question 6

Indications (3) - labetalol

Answer 6

❑ Severe hypertension and hypertensive emergencies
❑ Arterial hypertension in acute Ischemic stroke patients who are potential candidates for acute reperfusion therapy with a blood pressure level of Systolic >185 mmHg or diastolic >110 mmHg
❑ Management of blood pressure during reperfusion therapy and after reperfusion therapy; blood pressure level under 180 mmHg Systolic or under 105mmHg diastolic.

Question 7

Dosages (3) - labetalol

Answer 7

Hypertensive emergency: 10 - 20 mg SIVP initially; repeat 40 – 80 mg SIVP q 10 min to a maximum dose of 300 mg.

Acute Ischemic arterial hypertension in stroke prior to reperfusion therapy: 10 – 20 mg SIVP, repeat X 1

Blood pressure management peri/post reperfusion therapy: 10 mg SIVP followed by a continuous IV infusion of 2 -8 mg/minute: Mix: 1g /250 ml N/S [4 mg/ml]

Question 8

Contraindications (7) - labetalol

Answer 8

❑ Hypersensitivity
❑ CHF – severe LV failure
❑ Heart block (greater than 1st degree or 1st degree with PRI > 0.24 secs)
❑ Bradycardia < 60 bpm
❑ SBP < 100mmHg
❑ Cocaine in past 24 hours with chest pain
❑ Cardiogenic shock

Question 9

Precautions - labetalol

Answer 9

❑ Bronchial asthma
❑ Impaired hepatic function
❑ Impaired respiratory function
❑ Diabetes
❑ Not for Pediatrics

Question 10

Noteworthy notes to note - labetalol

Answer 10

❑ Unlike other beta-blockers, labetalol doesn’t decrease resting heart rate or cardiac output.
❑ A reasonable target is to lower blood pressure by 15% - 20%
❑ Concurrent IV administration with IV Ca Channel blockers can cause severe hypotension and bradycardia/heart block

Question 11

Kinetics (onset, peak and duration) - labetalol

Answer 11

IV
Onset: 2-5 mins
Peak: 5 mins
Duration: 16-18 hours

PO
Onset: 20 mins-2 hrs
Peak: 1-4 hrs
Duration: 8-12 hours

(Davis Drug Guide 16th ed.)