Labetalol (Normodyne, Trandate)

Question 1

Class

Answer 1

Beta adrenergic antagonist, antianginal

Question 2

Action

Answer 2

Binds with both the beta1 and beta2 receptors and alpha1 receptors in vascular smooth muscle. Inhibits the strength of the heart’s contractions, as well as heart rate. This results in a decrease in cardiac oxygen consumption

Question 3

Indications

Answer 3

ACS, SVT, severe hypertension

Question 4

Adverse Effects

Answer 4

Usually mild and transient; hypotensive symptoms. nausea/vomiting, brochospasm, arrhythmia, bradycardia, AV block

Question 5

Contraindications

Answer 5

Hypotension, cardiogenic shock, acute pulmonary edema, heartfailure, severe bradycardia, sick sinus syndrome, second- or third-degree heart block, asthma or acute bronchospasm, cocaine-induced ACS, known sensitivity. Use caution in pheochromocytoma, cerebrovascular disease or stroke, poorly controlled diabetes, with hepatic disease. Use with caution at lowest effective dose in chronic lung disease

Question 6

Adult Dosage (Cardiac Indications)

Answer 6

Note: Monitor blood pressure and heart rate closely during administration.

Maximum dose of 150 mg or give initial bolus and then follow with infusion at 2 to 8 mg/min

Question 7

Peds Dosage (Cardiac Indications)

Answer 7

0.4 to 1 mg/kg/hr to a maximum dosage of 3 mg/kg/hr

Question 8

Adult Dosage (Severe Hypotension)

Answer 8

Initial dose is 20 mg IV, IO slow infusion over a 2 min period. After the initial does, blood pressure should be checked every 5 mins. Repeat doses can be given at 10 min intervals.The second dose should be 40 mg IV, IO and subsequent doses should be 80 mg IV, IO, to a maximum total dose of 300 mg.

The effect on blood pressure typically will occur within 5 mins from the time of administration. Alternatively, may be administered via IV infusion at 2 mg/min to a total maximum dose of 300 mg

Question 9

Peds Dosage (Severe Hypotension)

Answer 9

0.4 to 1 mg/kg/hr IV, IO infusion with a maximum dose of 3 mg/kg/hr

Question 10

Special Considerations

Answer 10

Pregnancy class C