- |||||||||| Review, Journal: Cardiovascular Risk Management and Hepatitis C: Combining Drugs. (Pubmed Central) - Jul 9, 2020
The DAAs are victims of DDIs in combination with bisoprolol, carvedilol, labetalol, verapamil, and gemfibrozil. Despite there are many DDIs predicted in this review, most of these DDIs can be managed by monitoring the efficacy and toxicity of the victim drug or by switching to another CVD/DAA.
- |||||||||| carbamazepine / Generic mfg.
[VIRTUAL] Paroxysmal Sympathetic Hyperactivity in Glioblastoma Multiforme (ATS 2020 Virtual) - Jul 6, 2020 - Abstract #ATSI2020ATS-I_3073;
Due to low prevalence and complex pathophysiology, this syndrome is not well understood and often presents as a diagnostic dilemma.A 44-year-old male with a history of glioblastoma multiforme status-post right hemicraniectomy presented to the emergency department with acute encephalopathy and episodic seizure like activity despite being on carbamazepine and levetiracetam...Patient was started on IV labetalol and clonidine maintaining strict control for paroxysmal episodes...Having a high index of suspicion among patients with traumatic brain injury can aid in detecting the presence of this syndrome early in progression of disease. Timely identification can help in preventing delays in receiving appropriate treatment due to repetitive lab testing and might lead to better outcomes.
- |||||||||| labetalol / Generic mfg.
[VIRTUAL] Toxic Relationship with Labetalol Rare Angioedema (ATS 2020 Virtual) - Jul 6, 2020 - Abstract #ATSI2020ATS-I_2682;
While infusions of labetalol have successfully been used, prolonged administration in the intensive care unit requires vigilance 3 . This case was particularly unique as the patient, with no known history of C1- esterase inhibitor deficiency or angioedema presents with sudden onset angioedema in the setting of an beta-blocker overdose in the setting of co-managing an aortic dissection in the setting of hypertensive emergency.
- |||||||||| labetalol / Generic mfg.
Enrollment open, Trial initiation date: Outcome in Patients Treated With Intraarterial Thrombectomy - optiMAL Blood Pressure Control (OPTIMAL-BP) (clinicaltrials.gov) - Jun 28, 2020
P4, N=2036, Recruiting,
These results indicated that the thermoresponsive CSP would be a potential tool for separation of hydrophilic and hydrophobic chiral drugs and this paper provided a novel method for chiral separation in the future. Not yet recruiting --> Recruiting | Initiation date: Dec 2019 --> Jun 2020
- |||||||||| propranolol / Generic mfg., labetalol / Generic mfg.
[VIRTUAL] Successful Surgical Management of Graves’ Disease in Pregnancy () - Jun 20, 2020 - Abstract #ENDOI2020ENDO-I_2157;
Poor control of thyrotoxicosis is associated with pregnancy loss, prematurity, stillbirth, thyroid storm, and maternal congestive heart failure. Therefore, pre-pregnancy counseling is crucial to establish Euthyroid state for the safety of mother and fetus.
- |||||||||| Decadron (dexamethasone) / Merck (MSD)
[VIRTUAL] Polymicrobial Suppurative Thyroiditis Masquerading as Thyroid Storm () - Jun 20, 2020 - Abstract #ENDOI2020ENDO-I_1550;
She was prescribed atenolol and referred to Endocrinology...She was treated with methylprednisolone, propylthiouracil, and labetalol with improvement and transferred for concern of impending thyroid storm...Treatment was initiated with methimazole, SSKI drops, propranolol, and dexamethasone...Broad spectrum antibiotics were started and later narrowed to ampicillin-sulbactam...Current thyroid storm scoring systems are sensitive but not specific so an acute bacterial infection with thyrotoxicosis can easily meet criteria. While ultrasound is standard for assessing for thyroid abscesses, in the setting of high clinical suspicion, further imaging with contrasted neck CT is warranted.
- |||||||||| valsartan / Generic mfg.
[VIRTUAL] A Case of Delayed Hypoaldosteronism Following Unilateral Adrenalectomy for Primary Aldosteronism () - Jun 20, 2020 - Abstract #ENDOI2020ENDO-I_368;
This resulted in postoperative hypoaldosteronism once the affected adrenal gland was resected. This case demonstrates the need for continued monitoring of potassium, sodium, renin, and aldosterone following unilateral adrenalectomy for primary aldosteronism, especially in the setting of postoperative angiotensin receptor blocker use or other medications which can affect the renin-angiotensin-aldosterone system.
- |||||||||| [VIRTUAL] Steroid Induced Pheochromocytoma Crisis () - Jun 20, 2020 - Abstract #ENDOI2020ENDO-I_314;
Clinical Case: 58 year-old female with history controlled hypertension on Lisinopril 10 mg daily, presented to hospital with two day history of fatigue, shortness of breath, and abdominal pain...Ten hours after the start of prednisone the patient developed sudden onset hypertension with BP >200/100 mmHg for which she was given labetalol intravenously...Orthostatic hypotension here was related to epinephrine predominance pattern of secretion and volume depletion. Steroids should be avoided in patients with known pheochromocytoma or in those with an adrenal adenoma without a negative biochemical workup for a pheochromocytoma as it could precipitate an adrenergic crisis possibly by inducing catecholamine synthesis and release and sensitizing target organs to the effects of catecholamines.
- |||||||||| labetalol / Generic mfg.
Characteristics of Postpartum Patients Readmitted for Management of Hypertensive Disorders of Pregnancy () - Jun 20, 2020 - Abstract #ACOG2020ACOG_866;
Further investigation is needed to determine the effect of insurance on readmission rate and if social determinants of health impact postpartum hypertension follow up visits. The use of nifedipine versus labetalol also warrants further investigation as there appears to be a trend towards improved blood pressure control with nifedipine.
- |||||||||| labetalol / Generic mfg.
Clinical, Journal: Blood pressure reduction in hypertensive acute ischemic stroke patients does not affect cerebral blood flow. (Pubmed Central) - May 27, 2020
The volume of total hypoperfused tissue (CBF<18 ml/100 g/min) did not increase after labetalol (-1.1 ((-6.5)-(-0.2)) ml, p = 0.1), NTG (0 ((-1.5)-4.5) ml, p = 0.72), or no treatment 0.25 ((-10.1)-4.5) ml, p = 0.87). Antihypertensive therapy, based on presenting BP, in acute stroke patients was not associated with an increased volume of total hypoperfused tissue.
- |||||||||| labetalol / Generic mfg.
Journal: Hypertensive Urgency: An Undesirable Complication of a "Male Performance" Herbal Product. (Pubmed Central) - May 21, 2020
Hypertension failed to be controlled with multiple doses of oral clonidine and intravenous labetalol...WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Between 17-35% of the U.S. adult population may use herbal supplements on a sporadic or regular basis; pharmacologically active agents in herbal supplements may affect both a patient's presentation and response to treatment. Most patients do not mention over-the-counter and herbal products in their medication profile unless specifically asked, and therefore it is important for emergency physicians to be aware of the pharmacologic effects of herbal supplements in the evaluation and treatment of refractory severe hypertension.
- |||||||||| hydralazine hydrochloride / Generic mfg., labetalol / Generic mfg.
Retrospective data, Review, Journal: First-line antihypertensive treatment for severe hypertension in pregnancy: A systematic review and network meta-analysis. (Pubmed Central) - May 17, 2020
Collectively, CHIPS publications have provided evidence that women with non-severe pregnancy hypertension should receive 'tight' BP control achieved by a simple algorithm. Given the results of this systematic review and network meta-analysis, maternity care providers should feel comfortable initiating management of severe hypertension in pregnancy using oral nifedipine.
- |||||||||| nifedipine immediate release / Generic mfg., labetalol / Generic mfg.
Trial initiation date: P-PAT: Preeclampsia Postpartum Antihypertensive Treatment (clinicaltrials.gov) - May 11, 2020
P=N/A, N=300, Not yet recruiting,
On the other hand, study with ketoconazole revealed that this effect is dependent on CYP3A4 metabolites of carvedilol and labetalol (receptor study). Initiation date: Mar 2020 --> Aug 2020
- |||||||||| PK/PD data, Journal: Pharmacokinetic variability of beta-adrenergic blocking agents used in cardiology. (Pubmed Central) - Apr 30, 2020
We have shown a high interindividual pharmacokinetic variability that varies markedly in different beta-adrenergic blocking agents; the extreme being steady state ratios as high as 30 in metoprolol. A more personalized approach to the medical treatment of patients may be obtained by combining known pharmacokinetic information about variability, pharmaco-genetics and -dynamics, and patient characteristics, to avoid adverse events or lack of treatment effect.
- |||||||||| digoxin / Generic mfg., furosemide / Generic mfg., labetalol / Generic mfg.
Journal: Review of Cardiovascular Drugs in Pregnancy. (Pubmed Central) - Apr 29, 2020
Heart failure medications, including beta-blockers, furosemide, and digoxin, are relatively safe and can be used effectively...A summary of the safety of drugs during pregnancy and lactation from an online resource, LactMed by the National Library of Medicine's TOXNET database, is included. High-risk pregnant patients with cardiovascular disease require a multispecialty team of doctors, including health care providers from obstetrics and gynecology, maternal fetal medicine, internal medicine, cardiovascular disease specialists, and specialized pharmacology expertise.
- |||||||||| nitroglycerin / Generic mfg., labetalol / Generic mfg.
Trial completion, Surgery: Effects of Nitroglycerin Versus Labetalol on Tissue Perfusion During Deliberate Hypotension (clinicaltrials.gov) - Apr 27, 2020
P4, N=40, Completed,
High-risk pregnant patients with cardiovascular disease require a multispecialty team of doctors, including health care providers from obstetrics and gynecology, maternal fetal medicine, internal medicine, cardiovascular disease specialists, and specialized pharmacology expertise. Recruiting --> Completed
- |||||||||| Silenor (doxepin) / Currax
Journal: Magnetic nanocomposite-based SELDI probe for extraction and detection of drugs, amino acids and fatty acids. (Pubmed Central) - Apr 17, 2020
The feasibility of the SELDI probe to extract and detect three classes of drugs (labetalol, metoprolol, doxepin, desipramine, triprolidine and methapyrilene) spiked in wine is demonstrated...Graphical abstract A schematic presentation of carbon black-FeO magnetic probe for SELDI analysis of small molecules. The probe containing the analyte(s) is collected with the aid of a magnet and deposited on the target plate for mass spectrometry analysis.
- |||||||||| Decadron (dexamethasone) / Merck (MSD)
Polymicrobial Suppurative Thyroiditis Masquerading as Thyroid Storm (ENDOExpo, Booth 116) - Apr 1, 2020 - Abstract #ENDO2020ENDO_3818;
She was prescribed atenolol and referred to Endocrinology...She was treated with methylprednisolone, propylthiouracil, and labetalol with improvement and transferred for concern of impending thyroid storm...Treatment was initiated with methimazole, SSKI drops, propranolol, and dexamethasone...Broad spectrum antibiotics were started and later narrowed to ampicillin-sulbactam...Current thyroid storm scoring systems are sensitive but not specific so an acute bacterial infection with thyrotoxicosis can easily meet criteria. While ultrasound is standard for assessing for thyroid abscesses, in the setting of high clinical suspicion, further imaging with contrasted neck CT is warranted.
- |||||||||| carbamazepine / Generic mfg.
Paroxysmal Sympathetic Hyperactivity in Glioblastoma Multiforme (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area G) - Mar 15, 2020 - Abstract #ATS2020ATS_5440;
Due to low prevalence and complex pathophysiology, this syndrome is not well understood and often presents as a diagnostic dilemma.A 44-year-old male with a history of glioblastoma multiforme status-post right hemicraniectomy presented to the emergency department with acute encephalopathy and episodic seizure like activity despite being on carbamazepine and levetiracetam...Patient was started on IV labetalol and clonidine maintaining strict control for paroxysmal episodes...Having a high index of suspicion among patients with traumatic brain injury can aid in detecting the presence of this syndrome early in progression of disease. Timely identification can help in preventing delays in receiving appropriate treatment due to repetitive lab testing and might lead to better outcomes.
- |||||||||| labetalol / Generic mfg.
Toxic Relationship with Labetalol Rare Angioedema (PENNSYLVANIA CONVENTION CENTER, Hall D-E (200 Level), Area K) - Mar 15, 2020 - Abstract #ATS2020ATS_5001;
While infusions of labetalol have successfully been used, prolonged administration in the intensive care unit requires vigilance3. This case was particularly unique as the patient, with no known history of C1- esterase inhibitor deficiency or angioedema presents with sudden onset angioedema in the setting of an beta-blocker overdose in the setting of co-managing an aortic dissection in the setting of hypertensive emergency.
- |||||||||| A Case Report of Takayasu Arteritis in Pregnancy () - Feb 19, 2020 - Abstract #CRAAHPA2020CRA-AHPA_274;
Aspirin was continued throughout the pregnancy...Both mother and baby were doing well in follow-up. Obstetrics, obstetrical cardiology, nephrology, vascular surgery, and rheumatology were all involved in her peripartum care, emphasizing the importance of a multidisciplinary approach to pregnancy management in TAK patients.
- |||||||||| labetalol / Generic mfg.
Trial completion: The Effect of Intraoperative Labetalol on Time to Discharge (clinicaltrials.gov) - Feb 13, 2020
P2, N=172, Completed,
Among four dansylated AAs, dansylated valine and dansylated norvaline achieved baseline chiral separation with poly-β-SUGP and partial separation with poly-L-SULL. Recruiting --> Completed
- |||||||||| propranolol / Generic mfg., labetalol / Generic mfg.
Successful Surgical Management of Graves’ Disease in Pregnancy (ENDOExpo) - Feb 7, 2020 - Abstract #ENDO2020ENDO_2591;
Poor control of thyrotoxicosis is associated with pregnancy loss, prematurity, stillbirth, thyroid storm, and maternal congestive heart failure. Therefore, pre-pregnancy counseling is crucial to establish Euthyroid state for the safety of mother and fetus.
- |||||||||| valsartan / Generic mfg.
A Case of Delayed Hypoaldosteronism Following Unilateral Adrenalectomy for Primary Aldosteronism (ENDOExpo) - Feb 7, 2020 - Abstract #ENDO2020ENDO_2110;
This resulted in postoperative hypoaldosteronism once the affected adrenal gland was resected. This case demonstrates the need for continued monitoring of potassium, sodium, renin, and aldosterone following unilateral adrenalectomy for primary aldosteronism, especially in the setting of postoperative angiotensin receptor blocker use or other medications which can affect the renin-angiotensin-aldosterone system.
- |||||||||| Decadron (dexamethasone) / Merck (MSD)
Polymicrobial Suppurative Thyroiditis Masquerading as Thyroid Storm (ENDOExpo) - Feb 7, 2020 - Abstract #ENDO2020ENDO_1734;
She was prescribed atenolol and referred to Endocrinology...She was treated with methylprednisolone, propylthiouracil, and labetalol with improvement and transferred for concern of impending thyroid storm...Treatment was initiated with methimazole, SSKI drops, propranolol, and dexamethasone...Broad spectrum antibiotics were started and later narrowed to ampicillin-sulbactam...Current thyroid storm scoring systems are sensitive but not specific so an acute bacterial infection with thyrotoxicosis can easily meet criteria. While ultrasound is standard for assessing for thyroid abscesses, in the setting of high clinical suspicion, further imaging with contrasted neck CT is warranted.
- |||||||||| Steroid Induced Pheochromocytoma Crisis (ENDOExpo) - Feb 7, 2020 - Abstract #ENDO2020ENDO_1307;
Clinical Case: 58 year-old female with history controlled hypertension on Lisinopril 10 mg daily, presented to hospital with two day history of fatigue, shortness of breath, and abdominal pain...Ten hours after the start of prednisone the patient developed sudden onset hypertension with BP >200/100 mmHg for which she was given labetalol intravenously...Orthostatic hypotension here was related to epinephrine predominance pattern of secretion and volume depletion. Steroids should be avoided in patients with known pheochromocytoma or in those with an adrenal adenoma without a negative biochemical workup for a pheochromocytoma as it could precipitate an adrenergic crisis possibly by inducing catecholamine synthesis and release and sensitizing target organs to the effects of catecholamines.
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