Intravenous labetalol in severe hypertension.

Palu, Dal C; Ac, Pessina; Semplicini, A; Hlede, M; Morandin, F; Palatini, P; Sperti, G.; Gp, Rossi

doi:10.1111/j.1365-2125.1982.tb01896.x

Cited by 19 publications

(1 citation statement)

References 8 publications

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“…Administration of a1 blocking agents, as fentolamine or doxazosin, followed by a b blocker, but not in the opposite order to avoid enhancing a1-mediated vasoconstriction, are essential to achieve rapid control of BP. Among b blockers, labetalol, which has an a1 blocking effect when administered intravenously [44], is the only one that can be used i.v. without prior a1 blockade for the treatment of HEs in PPGL.…”

Section: Pheochromocytoma/paraganglioma (Ppgl)mentioning

confidence: 99%

Management of hypertensive emergencies: a practical approach

et al. 2021

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Background: Acute increases of high blood pressure values, usually described as 'hypertensive crises', 'hypertensive urgencies' or 'hypertensive emergencies', are common causes of patients' presentation to emergency departments. Owing to the lack of ad hoc randomized clinical trials, current recommendations/suggestions for treatment of these patients are not evidenced-based and, therefore, the management of acute increases of blood pressure values represent a clinical challenge. However, an improved understanding of the underlying pathophysiology has changed radically the approach to management of the patients presenting with these conditions in recent years. Accordingly, it has been proposed to abandon the terms 'hypertensive crises' and 'hypertensive urgencies', and restrict the focus to 'hypertensive emergencies'. Aims and Methods: Starting from these premises, we aimed at systematically review all available studies (years 2010-2020) to garner information on the current management of hypertensive emergencies, in order to develop a novel symptoms-and evidence-based streamlined algorithm for the assessment and treatment of these patients. Results and Conclusions: In this educational review we proposed the BARKH-based algorithm for a quick identification of hypertensive emergencies and associated acute organ damage, to allow the patients with hypertensive emergencies to receive immediate treatment in a proper setting.

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Section: Pheochromocytoma/paraganglioma (Ppgl)mentioning

confidence: 99%

Management of hypertensive emergencies: a practical approach

et al. 2021

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Labetalol: A Review of Its Pharmacology, Pharmacokinetics, Clinical Uses and Adverse Effects

1983

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Labetalol is a combined alpha- and beta-adrenoceptor blocking agent for oral and intravenous use in the treatment of hypertension. It is a nonselective antagonist at beta-adrenoceptors and a competitive antagonist of postsynaptic alpha 1-adrenoceptors. Labetalol is more potent at beta that at alpha 1 adrenoceptors in man; the ratio of beta-alpha antagonism is 3:1 after oral and 6.9:1 after intravenous administration. Labetalol is readily absorbed in man after oral administration, but the drug, which is lipid soluble, undergoes considerable hepatic first-pass metabolism and has an absolute bioavailability of approximately 25%. There are no active metabolites, and the elimination half-life of the drug is approximately 6 hours. Unlike conventional beta-adrenoceptor blocking drugs without intrinsic sympathomimetic activity, labetalol, when given acutely, produces a decrease in peripheral vascular resistance and blood pressure with little alteration in heart rate or cardiac output. However, like conventional beta-blockers, labetalol may influence the renin-angiotensin-aldosterone system and respiratory function. Clinical studies have shown that the antihypertensive efficacy of labetalol is superior to placebo and to diuretic therapy and is at least comparable to that of conventional beta-blockers, methyldopa, clonidine and various adrenergic neuronal blockers. Labetalol administered alone or with a diuretic is often effective when other antihypertensive regimens have failed. Studies have shown that labetalol is effective in the treatment of essential hypertension, renal hypertension, pheochromocytoma, pregnancy hypertension and hypertensive emergencies. In addition, preliminary studies indicate that labetalol may be of value in the management of ischemic heart disease. The most troublesome side effect of labetalol therapy is posture-related dizziness. Other reported side effects of the drug include gastrointestinal disturbances, tiredness, headache, scalp tingling, skin rashes, urinary retention and impotence. Side effects related to the beta-adrenoceptor blocking effect of labetalol, including asthma, heart failure and Raynaud's phenomenon, have been reported in rare instances.

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Hypertensive Emergencies

Michocki¹

1992

Applied Therapeutics

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Intravenous labetalol in severe hypertension.

Cited by 19 publications

References 8 publications

Management of hypertensive emergencies: a practical approach

Management of hypertensive emergencies: a practical approach

Labetalol: A Review of Its Pharmacology, Pharmacokinetics, Clinical Uses and Adverse Effects

Hypertensive Emergencies

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