Labetalol infusion in acute myocardial infarction with systemic hypertension.

Marx, Peter; Reid, D S

doi:10.1111/j.1365-2125.1979.tb04787.x

Cited by 43 publications

(15 citation statements)

References 11 publications

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“…However, at high levels of exercise there is some reduction in cardiac output (Edwards & Raftery, 1976). Cardiac output is also reduced at rest in patients with acute myocardial infarction, although this is predominantly related to a reduction in heart rate (Marx et al, 1979). Long-term continuous oral administration to hypertensive patients has confirmed the original findings (LundJohanssen, 1979;Koch, 1979).…”

supporting

confidence: 69%

“…We have seen one hypertensive patient develop subjective symptoms and objective signs of airways obstruction in labetalol that was reversed on dosage reduction without loss of BP control . The multicentre study reported two cases of heart failure in the study and the drug is probably best avoided in patients crucially dependent on their sympathetic drive to maintain cardiac output as suggested by the reduction in cardiac output seen after myocardial infarction (Marx & Reid, 1979).…”

Section: Side-effectsmentioning

confidence: 99%

“…Early investigations indicate that labetalol administered intravenously effectively reduces elevated BP in patients with acute myocardial infarction and reduces the after-load of the heart (Marx & Reid, 1979). Further studies in this area are awaited with interest.…”

Section: Pregnancy Hypertensionmentioning

confidence: 99%

“…After continuous oral administration to patients, small reductions in resting heart rate are usually recorded (Lund-Johansen, 1979;New Zealand Hypertension Study Group, 1979), although individual changes are influenced by the degree of resting sympathetic drive. In those patients with high resting heart rates and therefore high sympathetic drive, more marked reductions in resting heart rate are seen after labetalol, particularly after intravenous administration (Cumming et al, 1979b;Marx & Reid, 1979).…”

mentioning

confidence: 99%

See 3 more Smart Citations

Labetalol, an alpha‐ and beta‐adrenoceptor‐blocking agent: its use in therapeutics. A summary of the symposium.

Prichard¹,

Richards²

1979

Brit J Clinical Pharma

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supporting

confidence: 69%

Section: Side-effectsmentioning

confidence: 99%

Section: Pregnancy Hypertensionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Labetalol, an alpha‐ and beta‐adrenoceptor‐blocking agent: its use in therapeutics. A summary of the symposium.

Prichard¹,

Richards²

1979

Brit J Clinical Pharma

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“…After continuous oral administration to patients, small reductions in resting heart rate are usually found (Lund-Johansen, 1979), although individual changes are influenced by the degree of resting sympathetic drive. Marked reductions in resting heart rate after labetalol may follow intravenous administration Marx & Reid, 1979).…”

Section: Clinical Pharmacology and Haemodynamicsmentioning

confidence: 99%

Comparison of labetalol with other anti‐hypertensive drugs.

Prichard¹,

Richards²

1982

Brit J Clinical Pharma

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1 The anti‐hypertensive effects of labetalol have been compared and contrasted with other groups of anti‐hypertensive drugs in this review of the published literature. 2 The data show that the pharmacological and haemodynamic profile of labetalol in man is distinctly different from that of other specific anti‐hypertensive agents; namely the properties of competitive alpha‐and beta‐adrenoceptor blockade leading to haemodynamic effects of reduced blood pressure and peripheral vascular resistance with little accompanying changes in resting heart rate or cardiac output. 3 The anti‐hypertensive effects of labetalol are dose related. In fixed dose comparative studies equivalent anti‐ hypertensive effects to those of labetalol have been shown for individual drugs of the beta‐adrenoceptor‐blocking and diuretic groups. In dose titration studies, equivalent anti‐hypertensive effects at given doses of labetalol have been demonstrated for drugs of the following types: beta‐adrenoceptor blockers, beta‐blockers plus diuretics, methyldopa, adrenergic neurone blockers and the combination of beta‐blockers plus a peripheral vasodilator. 4 Comparing side‐effect liabilities, it is clear that quantitatively labetalol produces no greater burden of side‐effects than drugs of the beta‐adrenoceptor‐ blocking group. Qualitative differences, however, do exist; in particular, symptomatic postural hypotension is dose related and is more likely to occur when excessive doses (greater than 2 g daily) are used.

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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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Labetalol infusion in acute myocardial infarction with systemic hypertension.

Cited by 43 publications

References 11 publications

Labetalol, an alpha‐ and beta‐adrenoceptor‐blocking agent: its use in therapeutics. A summary of the symposium.

Labetalol, an alpha‐ and beta‐adrenoceptor‐blocking agent: its use in therapeutics. A summary of the symposium.

Comparison of labetalol with other anti‐hypertensive drugs.

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

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