Labetalol / Transdate

Question 1

Alternate Names

Answer 1

Carvedilol / Coreg Cost 4 - 26$

Question 2

Drug Class

Answer 2

Pharm: alpha and beta receptor blocker
Therapeutic: Antihypertensive, treatment of CHF (Coreg)

Question 3

Pharmacodynamics

Answer 3

Reduces BP by blocking access of NE to beta receptors and alpha 1 receptors; thereby lowering BP by several different mechanisms; patients differ in degree of beta-blockade vs alpha blockade

Question 4

Pharmacokinetics

Answer 4

Excellent absorption but high first pass effect, leading to F~25%; onset 1-2 hours after po, 2-5 minutes when given IV; extensively metabolized in liver by IID6

Question 5

Toxicity

Answer 5

Avoid in patient with Bradycardia, heartblock, CHF, asthma, shock; use with caution in patients with cardiomyopathy, pheochromocytoma, Pregnancy Class B

Question 6

Interactions

Answer 6

Additive effects with most other anti-hypertensives

Question 7

Special Consideration

Answer 7

Use reduced doses in patients with imparied liver function; dizziness is most troubling early side effect; most often used for hypertensive crises (with Nitroprusside)

Question 8

Indications and Dose / Route

Answer 8

Most commonly given IV, with initial small boluses of 20 mg, followed by continuous infusion at 2 mg / min; not usually given po for chronic treatment; 80 mg tid, or 240 SR once daily

Question 9

Monitor

Answer 9

BP HR

Question 10

Notes

Answer 10

Carvediol / Coreg - first beta blocker shown to improve survival with moderate to severe CHF -> reduce toxic remodeling in ventricular tissues
Also given to pregnant women during pregnancy
Also given to patients with pheochromocytoma?