Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Labetalol is a drug that is used for
treating high blood pressure. And is related to carvedilol (Coreg). Nerves from
the adrenergic nervous system travel from the spinal cord to arteries where they
release norepinephrine. Norepinephrine attaches to adrenergic receptors on
arteries and causes the arteries to contract, narrowing the arteries, and
increasing blood pressure. Labetalol blocks receptors of the adrenergic nervous
system. When labetalol attaches to and blocks the receptors, arteries expand,
resulting in a fall in blood pressure. The FDA approved labetalol in August
1984.
GENERIC AVAILABLE: Yes
PRESCRIPTION: Yes
PREPARATION: Tablets: of 100, 200 and 300 mg; Injection: 5 mg/ml
STORAGE: Tablets should be stored between 2-30 C (36-86 F).
PRESCRIBED FOR: Labetalol is used alone or in combination with other
drugs to reduce blood pressure.
DOSING: The recommended starting oral dose of labetalol is 100 mg twice daily and the dose can be increased by 100 mg twice
daily every 2-3 days based on the response of the blood pressure. Usual
maintenance doses are 200-400 mg twice daily. Patients with severely high blood
pressure may require 1.2 to 2.4 g daily.
Side effects may be less if labetalol
is given in three daily doses rather than two. Stopping or changing the dose of
the drug should be directed by a physician because serious side effects may
occur. The initial intravenous dose of labetalol is 20 mg injected over 2
minutes. Additional injections of 40 or 80 mg may be administered every 10
minutes as needed up to a total dose of 300 mg. Labetalol also may be
administered by intravenous infusion at 1-2 mg/minute.
DRUG INTERACTIONS: Labetalol can mask early warning symptoms of
hypoglycemia (low blood sugar) such as tremors and increased heart rate which
are the result of activation of the adrenergic nervous system. Therefore,
people with diabetes taking medications that lower blood sugar such as insulin or oral
antidiabetic medications may need to increase the frequency with which they
monitor their blood sugar in order to prevent hypoglycemia.
Combining labetalol
with tricyclic antidepressants such as amitriptyline (Elavil,
Endep), imipramine (Tofranil),
or nortriptyline (Pamelor) may lead to an increase in tremor which is a side
effect of tricyclic antidepressants.
If combined with adrenergic stimulating
drugs used for treating asthma, for example, albuterol (Proventil, Ventolin) or
pirbuterol (Maxair), the adrenergic blocking effects of labetalol may counteract
the effects of the stimulating drugs and reduce their effectiveness for treating
asthmatic attacks. More of the adrenergic drug may be needed.
Glutethimide (Doriden)
may decrease the effectiveness of labetalol by increasing its elimination. When
both drugs are used together, more labetalol or less glutethimide may be needed.
High blood pressure, also known as hypertension, is a repeatedly
elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above
140 with a diastolic pressure above 90. There are two causes of high blood pressure, primary and secondary. Primary high blood pressure is much more common that secondary and its basic causes or underlying defects are not always known. It is known that a diet high in salt increases the risk for high blood pressure, as well as high cholesterol. Genetic factors are also a primary cause. Secondary high blood pressure is generally caused by another condition such as renal hypertension, tumors, and other conditions. Treatment for high blood pressure is generally lifestyle changes and if necessary, diet.
Heart disease (coronary artery disease) is caused by a buildup of cholesterol deposits in the coronary arteries. Risk factors for heart disease include smoking, high blood pressure, heredity, diabetes, peripheral artery disease, and obesity. Symptoms include chest pain and shortness of breath. There are a variety of tests used to diagnose coronary artery disease. Treatment includes life-style changes, medications, procedures, or surgery.
Aortic dissection is a small tear in the large blood vessel that leads from the heart and supplies blood to the body. There are two types of aortic dissection, type 1 and type 2. Signs and symptoms of aortic dissection include a tearing or ripping pain, nausea, sweating, weakness, shortness of breath, sweating, or fainting. Treatment depends on the type of aortic dissection, and the severity of the tear in the aorta.
Coronary artery disease is the most common cause of death in the United
States. Over a million people each year will have a heart attack and 25% will
die before they get to the hospital while or in the Emergency Department.
Prevention is the key to treatment of heart disease.
Diagnosis of heart disease is often made by careful history taken by a health care
practitioner.
Some individuals may have atypical symptoms, including almost none at all.
The testing strategy to confirm the diagnosis and plan appropriate
treatment needs to be individualized for each patient diagnosed with heart
disease.
Treatment of heart disease depends upon the severity of disease, and is often directed by the
symptoms experienced by the affected individual.
Introduction to heart disease
The heart is like any other muscle, requiring oxygen and nutrient-rich blood for it t...
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