Page 152 - 2023 SMOG Digital

LABETALOL C Lactation Yes (Caution) Trade Name: Trandate
Class / Mechanism of Action
Beta Blocker with alpha blocking activity
Blocks alpha and beta-1/beta-2 adrenergic receptor sites. Onset IV: 2-5
minutes
Indications
Labeled Indications: Treatment of hypertension.
• IV: Treatment of severe hypertension and hypertensive emergencies
Unlabeled:
• Pre-eclampsia and severe hypertension in pregnancy, hypertension during acute ischemic stroke, and
Pediatric hypertension
Contraindications
• Hypersensitivity to labetalol or any component of the formulation
• Bradycardia <60bpm, heart block >1 degree
st
• Uncompensated heart failure, Cardiogenic shock
• Asthma
Adverse Reactions / Precautions
• Symptomatic hypotension with or without syncope, Monitor EKG closely
• Use with extreme caution in patients with compensated heart failure and Bradycardia
• Patient with bronchospastic diseases (reactive airway) should not use Beta blockers
Dose and Administration: ADULT PEDIATRIC Always Reference BROSELOW Tape
Acute Hypertension (hypertensive *Hypertension emergencies:
emergency/urgency: IV Continuous Infusion
Hypertensive Crisis • 0.4-1mg/kg/hr with a maximum of 3mg/kg/hr have
(Sys: >185/Dia: >110) been used; administration requires the use of an
• 10-20mg IV over 1-2 minutes. May repeat one infusion pump.
time • Intermittent bolus doses of 0.3-1mg/kg/dose
have been reported
Continuous Infusion: *Not 1 st Line medication for children
If continued medication required, 2-8mg/min
Note: Goal to lower MAP by no more than 25%
within minutes to one hour.

Pearls:
For inter-facility transports with confirmed Ischemic CVA, Intraparenchymal
Hemorrhagic CVA, or Spontaneous Non-traumatic SAH manage Hypertension
according to diagnosis or guidance from sending facility
• Ischemic CVA Lytic ineligible: SBP <220 and DBP <120
• Ischemic CVA Lytic eligible: SBP <185 and DBP <110
• Intraparenchymal Hemorrhagic CVA: SBP <180
• Non-traumatic SAH: SBP <160

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