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Trandate (Labetalol)
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Trandate

Trandate is used to treat severe high blood pressure (hypertension). Lowering high blood pressure Trandate helps prevent strokes, heart attacks and kidney problems.

Other names for this medication:

Similar Products:
Sectral, Tenormin, Coreg, Lopressor, Toprol, Corgard, Inderal

 

Also known as:  Labetalol.

Description

Trandate is a drug which is used for treating high blood pressure. It is related to carvedilol (Coreg). Nerves that are part of the adrenergic nervous system travel to most arteries where they release an adrenergic chemical norepinephrine. The norepinephrine attaches to receptors on the muscles of the arteries and causes the muscles to contract, narrowing the arteries, and increasing the blood pressure. Trandate blocks receptors of the adrenergic nervous system. When Trandate attaches to and blocks the receptors, the arterial muscles relax, and the arteries expand, resulting in a fall in blood pressure.

Generic name of Trandate is Labetalol.

Trandate is also known as Labetalol, Normodyne.

Brand name of Trandate is Trandate.

Dosage

Take this medicine with food or milk.

If you want to achieve most effective results do not stop taking Trandate suddenly.

Overdose

If you overdose Trandate and you don't feel good you should visit your doctor or health care provider immediately.

Storage

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) away from moisture, light and heat. Keep container tightly closed. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Trandate are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Do not take Trandate if you are allergic to Trandate components.

Be careful with Trandate if you're pregnant or you plan to have a baby, or you are a nursing mother.

Be careful with Trandate if you have a history of liver problems, heart problems, pheochromocytoma, diabetes, any allergies.

Do not take Trandate if you have a lung disease (asthma, COPD), advanced heart block, severe bradycardia, severe heart failure, post-CABG surgery.

This drug may make you dizzy for up to 3 hours after it is given. You should remain lying down during this time period in order to prevent falls.

You should get up slowly when rising from a seated or lying position.

Be very careful if you are driving machine.

Avoid alcohol.

Diabetic patients should be careful with Trandate.

Do not stop taking Trandate suddenly.

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Dynamic forearm exercise was performed in healthy subjects before and after intravenous labetalol, 1 mg/kg body weight. Labetalol produced a sustained fall in arterial blood pressure. Forearm blood flow decreased by 17.2% partly due to the reduced driving pressure and partly due to an increased vascular resistance. Forearm oxygen uptake decreased by 14.6%, suggesting an increased mechanical efficiency. Lactate release from the exercising forearm decreased by 17.6%. Forearm uptake of glucose and free fatty acids remained unchanged.

trandate medication pregnancy

High blood pressure (BP) complicates approximately 10% of all pregnancies. Hypertension in pregnancy falls into four categories: (1) preeclampsia-eclampsia, (2) chronic hypertension of whatever cause, (3) preeclampsia-eclampsia superimposed to chronic hypertension or renal disease, and (4) transient or late hypertension (gestational hypertension). Preeclampsia, the association of hypertension, proteinuria, and edema, accounts for more than 50% of all the hypertensive disorders of pregnancy and is a major cause of fetal and maternal morbidity and mortality. Unfortunately, distinguishing between preeclampsia and other causes of hypertension on clinical grounds can be difficult because of the lack of specific tests for differential diagnosis. Increased vascular resistance has been claimed as the primary cause of preeclampsia; however, a variable hemodynamic profile with relatively high cardiac outputs, normal filling pressures, and inappropriately high systemic vascular resistances is now reported by most investigators. Imbalance between vasodilator and vasoconstrictor eicosanoids may account for platelet activation and increased responsiveness to pressor peptides. Altered prostacyclin (PGI2) to thromboxane A2 (TxA2) ratio in maternal uteroplacental vascular bed may favor local platelet activation and vasoconstriction contributing to placental insufficiency and fetal distress. Alternatively, recent evidence seems to suggest that fetal umbilical placental circulation may be the site of the primary vascular injury. Whether low-dose aspirin prevents preeclampsia because it inhibits the excessive maternal TxA2 or whether the partial inhibition of fetal TxA2 is also of therapeutic value remains to be established. Treatment of severe hypertension in pregnancy is probably important to prevent cardiac failure or cerebrovascular accidents in the mother. The need for pharmacological therapy of mild to moderate hypertension is still debated, since no formal studies are available to clarify whether pharmacological treatment in such instances effectively reduces maternal or fetal risk. For the treatment of preeclampsia, hydralazine and nifedipine may be used when delivery is not applicable. Labetalol and diazoxide are effective for hypertensive emergencies. Life-threatening hypertension that does not respond to more conventional therapy is an indication for the use of sodium nitroprusside. For chronic hypertension, alpha-methyldopa remains the treatment of choice; if ineffective, hydralazine or beta-blockers are suitable. Effectiveness and safety of other molecules remain elusive.

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The alpha- and beta-blocking effects of labetalol are such that during and following exercise the haemodynamic benefits of beta-blockade outweigh the unfavourable effects, because the latter are diminished by the concomitant minor degree of alpha-blockade.

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Much more stable hemodynamic parameters during surgery in patients treated with remifentanil; labetalol was administered in 10% of patients in group F; no significant differences as regards the adverse effects and VAS. Faster awakening time was obtained in the remifentanil group as compared with the fentanyl group.

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This 32-yr-old man presented with uncontrolled hypertension for a few years for which he was treated with nifedipine. He subsequently defaulted follow-up. The patient presented again approximately three months from the day of surgery and was diagnosed to have a pheochromocytoma. The endocrinologist prescribed phenoxybenzamine and propanolol in addition to the nifedipine but the patient stopped taking both drugs six weeks prior to surgery due to their side effects. The patient was admitted the evening before surgery to the intensive care unit for rapid control of his blood pressure. Blood pressure was optimized with an infusion of labetolol and volume expansion titrated under central venous catheter and intraarterial blood pressure guidance throughout the night. On the morning of surgery, a magnesium sulfate infusion was started. The laparoscopic surgery proceeded uneventfully and the patient was hemodynamically stable. There were two transient periods of hypotension after induction and at removal of tumour respectively which were corrected with a brief adrenaline infusion. No adverse outcome was noted.

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Two simple and sensitive spectrofluorimetric methods have been developed for the determination of labetalol (LBT). In method A, the native fluorescence was measured at 432 nm after excitation at 312 nm. The second method (method B) is based on the formation of a ternary complex between zinc (II), eosin and LBT. The fluorescence intensity of the ternary complex was measured at 452 nm after excitation at 317 nm. Optimum conditions for the determination were also investigated. The linear range and detection limit for method A and B were found to be 1.25-30 µg/ml; 0.24 µg/ml and 0.5-4 µg/ml; 0.08 µg/ml, respectively. The proposed methods are simple, practical and relatively free of interference from coexisting substances. The methods have been applied to assess LBT in commercial tablets and human urine samples with good precision and accuracy.

trandate dosage

The effects of atropine administration during anticholinesterase poisoning on heart rate, blood pressure and electrocardiographic changes (ECG) were studied in the cat. Administration of atropine intravenously during anticholinesterase poisoning caused a significant increase in heart rate and blood pressure; ECG changes were also seen. The simultaneous intravenous administration of atropine and labetalol during anticholinesterase poisoning abolished the increase in blood pressure and heart rate; ECG readings remained normal. It is suggested that labetalol may be a useful adjuvant in the treatment of anticholinesterase poisoning especially in patients with compromised heart function.

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The clinical effects, the exercise test answer, the left ventricular function by polygraphyc test after administration at middle term of Metoprolol and Labetalol have been evaluated in 20 patients with moderate and non complicated essential hypertension. The study was a double blind cross-over between Metoprolol and Labetalol (270 mg/die per os). Both drugs induced a reduction of PAOS and PAOD. The exercise test induced in all patients a decrease of PAOS and PAOD, showing an improvement of strain tolerance. The normalization of PEP and non modification of LVET seem to confirm that the treatment with Metoprolol and with Labetalol, neither induces significant modification of left ventricular function.

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There were no differences in blood loss and quality of surgical field among the study groups. Patients in the hypocapnia group demonstrated the highest, and in the hypercapnia group, the lowest, requirements for remifentanil, labetalol, and administration of the antihypertensive medications in general. The computed tomography-graded severity of sinonasal disease and duration of surgery were the only independent predictors of intraoperative blood loss.

trandate iv dose

This is a case of a 28-yr-old man who underwent general anaesthesia for emergency repair of a right lid laceration and lacrimal apparatus. Following induction of anaesthesia and local nasal application of phenylephrine (0.25%) he developed transient elevation of blood pressure, which was treated immediately with labetalol. Subsequently the patient developed acute pulmonary oedema which responded to treatment with morphine and furosemide. The diagnosis of pulmonary oedema was confirmed by blood gas studies, chest x-ray and serial echocardiograms. Subsequent investigation revealed that he was a cocaine user, as the urine tested positive for cocaine. Considering that the patient was young and otherwise healthy and that the hypertension was transient, it is unlikely that phenylephrine was the main cause of pulmonary oedema. Cardiac morbidity was most likely precipitated by the interaction of phenylephrine-induced hypertension with a cocaine-depressed myocardium.

trandate drug classification

Vagal stimulation is preferentially central and directly linked to the electric excitation of the lateral dorsal motor nucleus of the vagus nerve. Younger patients with no cardiac history are more at risk. This could be explained by the fact that juvenile tissue conducts electricity more rapidly than senescent (the difference being probably due to the fibrosis and adipose tissue which reduce its conductive capacity). Finally, it is appropriate to question the direct therapeutic aspect of vagal stimulation which constitutes an experimental treatment of resistant depression.

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A zone of hypoperfusion surrounding acute intracerebral hemorrhage (ICH) has been interpreted as regional ischemia. To determine if ischemia is present in the periclot area, the authors measured cerebral blood flow (CBF), cerebral metabolic rate of oxygen (CMRO2), and oxygen extraction fraction (OEF) with positron emission tomography (PET) in 19 patients 5 to 22 hours after hemorrhage onset. Periclot CBF, CMRO2, and OEF were determined in a 1-cm-wide area around the clot. In the 16 patients without midline shift, periclot data were compared with mirror contralateral regions. All PET images were masked to exclude noncerebral structures, and all PET measurements were corrected for partial volume effect due to clot and ventricles. Both periclot CBF and CMRO2 were significantly reduced compared with contralateral values (CBF: 20.9 +/- 7.6 vs. 37.0 +/- 13.9 mL 100 g(-1) min(-1), P = 0.0004; CMRO2: 1.4 +/- 0.5 vs. 2.9 +/- 0.9 mL 100 g(-1) min(-1), P = 0.00001). Periclot OEF was less than both hemispheric OEF (0.42 +/- 0.15 vs. 0.47 +/- 0.13, P = 0.05; n = 19) and contralateral regional OEF (0.44 +/- 0.16 vs. 0.51 +/- 0.13, P = 0.05; n = 16). In conclusion, CMRO2 was reduced to a greater degree than CBF in the periclot region in acute ICH, resulting in reduced OEF rather than the increased OEF that occurs in ischemia. Thus, the authors found no evidence for ischemia in the periclot zone of hypoperfusion in acute ICH patients studied 5 to 22 hours after hemorrhage onset.

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Hypertensive emergencies, though uncommon in children, are potentially life threatening. While targeting blood pressure reduction to below the 90th percentile for age, gender and height, mean arterial blood pressure should be gradually lowered by one-fourth of the planned reduction over 8-12 h, a further fourth over the next 8-12 h, and the final 50% over the 24 h after that. Frequent invasive or non-invasive blood pressure monitoring is essential, as is monitoring for sensorial alteration and loss of papillary reflexes. Few antihypertensive agents have been examined in children. Continuous intravenous infusions of short acting drugs such as nitroprusside, labetalol and nicardipine are preferred to intravenous boluses of hydralazine or diazoxide. If severe symptoms are absent, oral agents such as nifedipine, clonidine, minoxidil, hydralazine, labetalol, captopril, and prazosin may be used. Nicardipine and labetalol are particularly suited in emergencies with intracranial bleeding or ischemic stroke, while furosemide, sodium nitroprusside and nitroglycerine are useful in congestive cardiac failure. Therapy with oral antihypertensive drugs should be instituted within 6-12 h of parenteral therapy, and the latter gradually withdrawn over the next 12-48 h. Oral agents have limited application as primary therapy, except when administration of intravenous infusion is likely to be delayed. This article provides a summary of the clinical approach to evaluation and management of severe symptomatic hypertension in children.

trandate dose

The effects of labetalol, an alpha- and beta-adrenoceptor blocking drug, on blood pressure, heart rate, plasma renin activity (PRA) and plasma aldosterone were studied in 17 adult patients with essential hypertension. Following a total dose of 1 g labetalol administered over a 48-hour period, there was a rapid and significant fall in systolic and diastolic BP averaging 16,5 +/- 7,9%/14,8 +/- 7,5% respectively supine, 18,7 +/- 8,3%/17,8 +/- 7,2% standing and 23,9 +/- 7,1%/16,8 +/- 10,3% after moderate exercise; 24 hours after labetalol was discontinued, the BP had gone up but was still below pretreatment values. Bradycardia remained slight throughout. During treatment a significant decrease in PRA (mean : 45%) was observed in all patients and found to correlate in standing position with changes in standing and post-exercise mean arterial pressure. There was no significant changes in plasma aldosterone. Side-effects were mild and limited to tingling of the scalp in 5 patients. No clinical symptoms of postural hypotension were recorded.

trandate drug class

While there is general agreement on the natural history, pathology, and pathophysiology of hypertension, there continues to be controversy over the selection of specific antihypertensive agents. All antihypertensive agents will, by definition, lower blood pressure, and factors beyond side effects and other difficulties associated with therapy form the basis of selecting specific agents. One of these factors is the effect of a given drug on core organ function. Propranolol was the first beta-adrenoceptor-blocking agent introduced for the treatment of hypertension. Initiation of therapy with propranolol may result in a decline in blood pressure more at the expense of cardiac function due to a concomitant rise in total peripheral resistance. Furthermore, propranolol may result in a decline in both glomerular filtration rate (GFR) and renal blood flow (RBF). In contrast, cardioselective beta-blockers or those with intrinsic sympathomimetic activity may not adversely affect renal function. It had been predicted that nadolol, a noncardioselective beta-blocker without intrinsic sympathomimetic activity, should result in decreased renal function. In contrast, observations demonstrated a preservation or improvement in both RBF and GFR, suggesting the presence of an alternative effective mechanism. Recent additions to the beta-adrenolytic group of antihypertensive agents include drugs with concurrent beta-blockade and vasodilation. This vasodilatation may be achieved through agonist properties resulting in lesser increases in vasomotor tone and smaller, if any, decreases in cardiac output. Alternatively, vasodilation may be achieved by concomitant alpha-adrenoceptor blockade, such as with labetalol. This agent preserves GFR and RBF during therapy of hypertension, in patients with normal as well as diminished renal function and hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

trandate drug interactions

There is a major controversy over the relative value of anti-hypertensive drugs in hypertension in pregnancy. Our purpose was to study two different beta-adrenolytic drugs, atenolol, a cardioselective beta blocker, and labetalol, an alpha-beta blocker. Fifty-six hypertensive (BP greater than 140/90 mmHg) pregnant women were treated either with atenolol or labetalol. The patients were divided into two subgroups for which there were no statistical differences with regard to age, number of previous pregnancies, initial level of blood pressure and uricemia, proteinuric pre-eclampsia, beginning of therapeutic trial and delivery. The average daily dosage was 144.6 +/- 47.8 mg day-1 with atenolol and 614 +/- 47.8 mg day-1 with labetalol. This study shows: the same anti-hypertensive effect of the two drugs with control of blood pressure in 82% of the cases; a birth-weight significantly higher with labetalol (3280 +/- 555 g) than with atenolol (2750 +/- 630 g) (P less than 0.001); two still-births with atenolol; no adverse effects of the drugs during pregnancy and the neo-natal period; the trans-placental passage of atenolol and labetalol as shown by plasma dosages in the mothers and the new-born. It is concluded that atenolol and labetalol are safe and they are usually effective in the control of the hypertension complicating pregnancy. But labetalol appears to be better able to prevent the appearance of fetal growth retardation.

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Cardiac phaeochromocytoma is a rare cause of endocrine hypertension. We report a case of a 25-year-old woman, who presented with severe hypertension and intermittent chest pain. The patient denied typical phaeochromocytoma spells of palpitation, headache, and diaphoresis. The 24-hr urinary excretion of norepinephrine was increased sevenfold above the upper limit of normal; however, the excretion of total metanephrines, epinephrine, and dopamine were normal. Computed tomography (CT) scan of the abdomen was normal. An 131I-labelled metaiodobenzylguanidine (MIBG) scan was falsely negative while the patient was taking labetalol. The cardiac phaeochromocytoma was localized with indium-111-pentetreotide scintigraphy and chest magnetic resonance imaging scan. Repeat 123I-MIBG scintigraphy was positive after discontinuing labetalol. The cardiac phaeochromocytoma was located in the right atrial groove, adjacent to the tricuspid valve, and contained multiple feeder arteries from the right coronary artery. After treatment with volume expansion, alpha-methyl-p-tyrosine, and alpha- and beta-adrenergic blockade, surgical resection was performed. While under cardiopulmonary bypass, coronary bypass grafting and tricuspid annuloplasty were performed to facilitate the complete surgical resection of the 4.5-cm tumour. The surgical course was uncomplicated, with complete cure of hypertension and normalization of catecholamine excretion. Post-operative cardiac function, as measured by echocardiogram, was normal. Although cardiac phaeochromocytoma may be highly vascular, invasive and difficult to resect, it can be cured.

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Blood pressure (BP) elevations may correspond to different clinical situations. Hypertensives emergencies are situations that require immediate reduction in BP because of acute or rapidly progressing target organ damage: accelerated malignant hypertension, hypertensive encephalopathy, acute myocardial infarction, acute aortic dissection, acute left ventricular failure, and eclampsia. Hypertensive urgencies are those with marked elevated BP in which it is desirable to reduce BP progressively within few hours, such as severe hypertension, progressive target organ damage, perioperative hypertension. Cerebrovascular accidents have to be individualized. In most patients in the immediate post-stroke period, BP should not be lowered. Caution is advised in lowering BP in these patients because excessive falls may precipitate cerebral ischemia. In situations without symptoms or progressive target organ it is necessary to exclude proximate causes of elevated BP such as pain and elevated BP alone rarely requires antihypertensive treatment. Among parenteral antihypertensive (AH) drugs labetalol, nicardipine, urapidil, and nitroprussiate are generally used, and the choice of AH drug depends on the clinical situation. It is not required to normalize BP immediately but to reduce mean BP no more than 25%, then toward 160/100 mmHg as recommended by JNC VI, in order to avoid an impairment of renal, cerebral or coronary ischemia. Oral long-acting dihydropyridines are often subsequently administrated, except in myocardial ischemia. Therapeutic attitudes vary considerably according to the clinical situation: abstention, immediate decrease or progressive decrease in BP have to be decided.

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We explored the sympatholytic property of dexmedetomidine, especially its role in intraocular pressure (IOP) reduction, haemodynamic stability, and attenuation of extubation response.

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The incidence of perioperative stroke was 55 of 57,218 (0.09%). Preoperative metoprolol was associated with an approximately 4.2-fold increase in perioperative stroke (P < 0.001; 95% CI, 2.2-8.1). Analysis of matched cohorts revealed a significantly higher incidence of stroke in patients taking preoperative metoprolol compared with atenolol (P = 0.016). However, preoperative metoprolol was not an independent predictor of stroke in the entire cohort, which included patients who were not taking β blockers. The use of intraoperative metoprolol was associated with a 3.3-fold increase in perioperative stroke (P = 0.003; 95% CI, 1.4-7.8); no association was found for intraoperative esmolol or labetalol.

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Rhinoplasty is one of the most common surgeries of the plastic surgery and as well as ear, throat and nose. Intra-operative bleeding during surgery is one of the most important factors that may impair the surgeon's job. Providing a clean blood-free surgical filed makes the operation faster, easier and with a better quality. One way to achieve this goal is to induce hypotension. This study aimed to compare the impacts and outcomes of administration of labetalol or nitroglycerin for this purpose.

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Preeclampsia is an exaggerated maternal inflammatory state with over-expression of placental soluble fms-like tyrosine kinase 1 (sFlt-1). It is also associated with shallow trophoblast invasion and inadequate transformation of uterine spiral arteries. Antihypertensive drugs administrated in preeclampsia to control blood pressure have been reported to regulate placental and circulating cytokine production from women with preeclampsia. Whether they could modulate the interaction between trophoblast and endothelial cells are not investigated.

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1 Nineteen pregnant patients whose mean arterial pressure (MAP) was persistently greater than or equal to 103.3 mmHg were given labetalol or methyldopa. 2 Singificant falls (P less than 0.001) in BP only occurred in the group treated with labetalol, and daily BP control was better in this group. 3 Two severely hypertensive patients were successfully treated with intravenous labetalol. 4 There was a higher incidence of spontaneous labour in the labetalol group and a significant difference (P less than 0.05) in the Bishop score of the cervix between the two groups. 5 There were no apparent detrimental effects on the foetus antenatally, during labour or post partum. 6 Slight breathlessness in one patient treated with labetalol was the only side-effect observed but drowsiness, headache and postural hypotension were reported in patients receiving methyldopa.

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Drug-induced sexual dysfunction is well known to occur with antihypertensive drugs in men. There are much less data on the effects of drugs on female sexual function. The physiology of the female sexual response has similarities to that of the male sexual response and there are therefore good reasons for suspecting that antihypertensive drugs are likely to adversely affect sexual function in women. Present evidence suggests that clonidine, methyldopa, guanethidine and reserpine are associated with adverse effects on sexual function. In healthy volunteers, labetalol appears to reduce vaginal lubrication, but there are no studies in patients receiving the drug therapeutically. Thiazide diuretics may be associated with the worsening of sexual problems, which interestingly appear to be ameliorated by weight reduction. Present evidence on the effects of vasodilators is limited but the evidence suggests that sexual function in women receiving calcium antagonists is not altered by changing to an angiotensin converting enzyme (ACE) inhibitor. Although present evidence suggests that effects on female sexual function may not be very great, it should be recognised that there are very few data in this area. Further work is clearly necessary.

trandate pediatric dose

A total of 1184 consecutive adults with acute severe hypertension (systolic blood pressure [SBP] ≥ 180 mm Hg, diastolic blood pressure ≥ 110 mm Hg), without a neurologic reason for admission, receiving two or more intermittent intravenous antihypertensive doses or a continuous intravenous infusion within 24 hours of hospitalization.

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trandate medication 2017-05-17

Two vasodilating beta-blockers, dilevalol and pindolol, were studied for their buy trandate effects on the development of hypertension and left ventricular hypertrophy in spontaneously hypertensive rats. Dilevalol has agonist activity at beta 2-, whereas pindolol interacts with both beta 1- and beta 2-receptor subtypes. Groups of 7-week old spontaneously hypertensive rats were given dilevalol (30 mg/kg) or pindolol (3 mg/kg) in the drinking water for 3 months. A control group of spontaneously hypertensive rats and age-matched normotensive Wistar Kyoto rats were also used. Systolic blood pressure and heart rate were recorded weekly. Cardiac structural changes were determined by morphometric analysis. Control spontaneously hypertensive rats developed hypertension and left ventricular hypertrophy as compared with normotensive rats. Dilevalol and pindolol prevented the rise in blood pressure, but only dilevalol lowered heart rate. However, neither of the compounds prevented the development of left ventricular hypertrophy, but they differently influenced myocardial structure as measured by the volume fraction of fibrotic tissue in the left ventricle. Dilevalol markedly prevented the amount of fibrosis to a level comparable to that found in normotensive rats, whereas pindolol had a weaker effect. The data suggest that individual pharmacologic characteristics, such as partial agonist activity of each beta-blocker examined, may account for differential effects on the myocardial structure.

trandate 200 mg 2017-02-15

Physical examination, laboratory evaluations including full blood count buy trandate , liver function tests, electrolytes, renal function tests, screening for glomerular-based disease, 24-h urine collection for total protein, analysis of serum anti-angiogenic and angiogenic factors, fetal ultrasonography and placental Doppler examination.

trandate drug class 2017-05-26

To review outcomes in randomised controlled trials buy trandate comparing hydralazine against other antihypertensives for severe hypertension in pregnancy.

trandate tablets 200mg 2017-04-11

Sotos' syndrome (synonym: cerebral gigantism) is the association of mental retardation, macrocephaly and prenatal onset of accelerated growth. The rapid skeletal growth may account for a 4% incidence of scoliosis. General anaesthesia using halothane or enflurane in nitrous oxide and oxygen, with opioid supplementation and labetalol to induce moderate hypotension, appeared to be a satisfactory technique for buy trandate corrective spinal surgery. The potential problems are discussed, with mental retardation and sometimes aggressive behaviour contraindicating a "wake-up" test. Extradural somatosensory evoked potential monitoring is a satisfactory alternative. Hook failures seem more likely than in patients undergoing surgery for adolescent idiopathic scoliosis.

trandate dosing 2015-12-05

Carbon dioxide pneumoperitoneum for buy trandate laparoscopic surgery increases arterial pressures, heart rate, and systemic vascular resistance. In this randomized double-blind placebo-controlled clinical study, we investigated the efficacy of gabapentin premedication to provide perioperative hemodynamic stability in patients undergoing laparoscopic cholecystectomy.

trandate tab 2016-06-08

Labetalol (Trandate) 50 mg i.v. was administered to a pre-eclamptic primigravida with an asphytic fetus prior to cesarean section, in order to reduce the risk of excessive increase in blood pressure buy trandate during induction of anesthesia. Blood pressure fell rapidly from 170/110 to 115/85 mmHg. A dead infant was born. Oral labetalol is arguably a suitable remedy for pre-eclampsia, but if i.v. administration is necessary, an initial dose of 5-10 mg is recommended.

trandate 400 mg 2015-06-02

An improved high-performance liquid chromatographic (HPLC) assay has been developed for the analysis of labetalol in human plasma. The method is based on the combined use of an automated sample processor, reversed-phase analysis on a microparticulate polymer-based HPLC column and fluorescence detection. The pH stability of the polymeric column packing material buy trandate allowed the use of a mobile phase adjusted to pH 9.5, which was optimal for the fluorescence of labetalol. Assay validation was undertaken over the labetalol concentration range 2-100 ng/ml. Calibration curves were essentially linear, and the mean coefficient of variation was 5.3%. The assay has been used for the analysis of clinical samples in support of pharmacokinetic studies.

trandate safe dose 2017-04-24

This article reviews the pathophysiology of hypertension and either insulin resistance or dyslipidemia as well as treatment effects from glucose- and lipid-lowering regimens on cardiovascular morbidity and mortality. Based on a PubMed literature search from January 1980 to December 2008, the effects of nonvasodilating (atenolol, metoprolol, and propranolol) and vasodilating beta-blockers (carvedilol, labetalol, and nebivolol) on parameters of glucose and lipid metabolism buy trandate in hypertension are presented. Preference for clinical trial inclusion was given to randomized, controlled trials with at least 100 patients. Limitations of a drug class literature review may include trial inclusion bias with associated result skewing and underrepresentation of an individual agent, which may give different results.

trandate drug classification 2015-03-19

To review the published evidence for the effectiveness buy trandate of oral antihypertensive therapy for severe hypertension in pregnancy.

trandate iv dosage 2017-01-01

The hypertensive disorders of pregnancy (HDP) are a leading cause of maternal mortality and morbidity in both well and under-resourced settings. Maternal, fetal, and neonatal complications of the HDP are concentrated among, but not limited to, women with pre-eclampsia. Pre-eclampsia is a systemic disorder of endothelial cell dysfunction and as such, blood pressure (BP) treatment is but one aspect of its management. The most appropriate BP threshold and goal of antihypertensive treatment are controversial. Variation between international guidelines has more to do with differences in opinion rather than differences in published data. For women with severe hypertension [defined as a sustained systolic BP (sBP) of ≥160 mmHg and/or a diastolic BP (dBP) of ≥110 mmHg], there is consensus that antihypertensive therapy should be given to lower the maternal risk of central nervous system complications. The bulk of the evidence relates to parenteral hydralazine and labetalol, or to oral calcium channel blockers such as nifedipine capsules. There is, however, no consensus regarding management of non-severe hypertension (defined as a sBP of 140-159 mmHg or a dBP of 90-109 mmHg), because the relevant randomized trials have been underpowered to define the maternal and perinatal benefits and risks. Although antihypertensive buy trandate therapy may decrease the occurrence of BP values of 160-170/100-110 mmHg, therapy may also impair fetal growth. The potential benefits and risks do not seem to be associated with any particular drug or drug class. Oral labetalol and methyldopa are used most commonly, but many different β-adrenoceptor blockers and calcium channel blockers have been studied in clinical trials.

trandate brand name 2016-06-04

Patients with essential hypertension were treated for four weeks with the alpha- and beta-adreno-receptor blocking agent labetalol. Urinary excretion of total catecholamines, metanephrine plus normetanephrine and vanillylmandelic acid was measured with various methods before and during treatment. An unidentified substance interfering with the fluorimetric method for catecholamines and the photometric assay for metanephrines caused falsely high values of those substances. Using appropriate methodology no changes of total catecholamines, metanephrine plus buy trandate normetanephrine and vanillylmandelic acid excretion were found after labetalol therapy. Our findings are important in preventing errors in the diagnosis of pheochromocytoma as well as in the evaluation of the effects of labetalol on the sympathetic nervous system in man.

trandate tabs 2015-07-19

Effects produced buy trandate both by single intravenous drop-by-drop labetalol, 1 mg/kg (29 patients), sublingual obsidan, 20 mg (14 patients) and a 3-day course treatment with labetalol, 200-600 mg/day, and obsidan (80-160 mg/day) on systemic, intracardiac, and regional hemodynamics and oxygen supply of the body were comparatively studied in 43 patients in early periods of myocardial infarction. As compared with obsidan, labetalol caused favourable hemodynamic changes mostly pronounced in patients with concurrent arterial hypertension. The hemodynamic effects in arterial hypertension were found to come about by virtue of largely an alpha-adrenoblocking effect of the agent whereas in the absence of hypertension it was beneficial due to a combined alpha- and beta-adrenoblocking effect.

trandate pediatric dose 2016-10-04

The aim of this study was to compare the effect of dilevalol and captopril on blood pressure and heart rate in buy trandate hypertensive subjects, both at rest and during bicycle exercise. Thirty mild hypertensive patients (24 men, 6 women), aged 34-55, were studied in a randomized, double-blind, parallel group trial. After a 3-week placebo run-in, patients were randomized to receive either dilevalol (200 mg once daily) or captopril (50 mg twice daily) for 4 weeks. Dilevalol-treated patients whose diastolic blood pressure had not decreased by more than 8 mmHg from baseline (or to less than 95 mmHg) were given 400 mg once daily for a further 2 weeks. Treatment was stopped for all other patients. Blood pressure and heart rate were measured at rest and during bicycle exercise tests 4 ("peak") and 24 hours ("trough") after dosing in the dilevalol group and 4 ("peak") and 12 hours ("trough") after dosing in the captopril group. At the end of the placebo run-in, mean resting blood pressure was 156/102 mmHg in the dilevalol group and 157/103 in the captopril group. Six patients had blood pressure normalization with captopril and 9 with dilevalol 200 mg; a further 2 patients achieved normalized blood pressure levels with dilevalol 400 mg.(ABSTRACT TRUNCATED AT 250 WORDS)

trandate storage 2016-09-09

Labetalol was administered as the sole antihypertensive agent to 20 ambulatory patients with mild to moderate hypertension. The mean systolic and diastolic blood pressures (+/- standard error of the mean) with the patients sitting fell significantly (P < 0.001), from 145.5 +/- 3.2 and 103.7 +/- 1.6 mm Hg respectively at the start of labetalol therapy (after a period free of antihypertensive medication) to 125.7 +/- 2.0 and 87.2 +/- 1.1 mm Hg by the end of the trial. The diastolic blood pressure was well controlled (90 mm Hg or less Duphaston Tablet ) with labetalol therapy in 90% of the patients. The medication was well tolerated, and no orthostatic fall in the diastolic blood pressure was observed. Pharmacologically labetalol most closely resembles a combination of a nonselective beta-adrenergic blocker like propranolol and a postsynaptic alpha-adrenergic blocker like prazosin.

trandate 100mg dosage 2015-10-13

1 Fourteen patients whose lying diastolic blood pressure was persistently 110 mmHg or greater were given labetalol 0.5-- Zovirax Generic 1 mg/kg intravenously. 2 The maximum hypotensive effect developed between 20 and 40 min, and on average lasted 3 h. The lying systolic mean blood pressure fell by 30 mmHg and the lying diastolic blood pressure by 17 mmHg (P less than 0.001). 3 This acute hypotensive effect was associated with a significant reduction in the peripheral resistance (P less than 0.02). The hypotension was not associated with significant secondary changes in the stroke volume or pulse rate. 4 The above 14 patients plus 1 additional subject received labetalol orally at a daily dose ranging from 150-2400 mg. The mean lying systolic blood pressure fell by 22 mmHg (P less than0.01) and the mean lying diastolic blood pressure by 26 mmHg (P less than 0.001). The standing values were similar and postural hypotension at this dose did not develop. There was no significant change in the pulse rate. 5 Renal function was monitored by estimates of plasma creatinine and creatinine clearance. Some patients were followed for 2 yr and others for a few months. With the long-term patients, there was no significant reduction in either measurement although in a few patients a slight reduction in creatinine clearance was observed.

trandate 20 mg 2016-03-25

Isometric tension recordings were performed under physiological conditions Trileptal Reviews Bipolar on human umbilical arterial rings (n=30). The in vitro effects of labetolol, hydralazine, alpha-methyldopa, nifedepine and magnesium sulphate (at concentration ranges from 1 nanomolar to 1 millimolar), and their respective vehicle controls, were measured. Results were expressed as -logEC50 (pD2) and mean maximal inhibition values for each compound.

trandate maximum dose 2015-05-21

The effects of propranolol, oxprenolol, pindolol, labetalol, and atenolol on the isoproterenol-stimulated slow calcium current as well as on spontaneous slow calcium and fast sodium currents were studied in frog trabeculae by the double sucrose bridge technique. Administration of beta-adrenoblockers in low doses (10(-7)-10(-6)M) antagonized the stimulatory effect of isoproterenol on the slow calcium current (pindolol greater than oxprenolol greater than or equal to propranolol = labetalol greater than atenolol). When Deltasone Online Pharmacy administered in high doses (2 X 10(-6)-10(-4)M) the beta-adrenoblockers reduced the slow calcium current. Meanwhile, some of them (propranolol, oxprenolol, labetalol) suppressed the fast sodium current.

trandate iv dose 2017-06-13

Twenty-four patients were allocated randomly to 3 Altace Dose Range groups. The control group were anaesthetised with isoflurane, and normotension maintained for 30 min before hypotension was induced with isoflurane and surgery started. In the labetalol group, this drug was given i.v. to obtain a mean arterial pressure (MAP) of 60 mm Hg for 30 min before surgery and hypotension maintained with labetalol during the operation. In the isoflurane group, hypotension was induced to a MAP of 60 mm Hg for 30 min before surgery and continued throughout the procedure. All 3 groups received metoprolol i.v. before hypotension was established. Blood samples were collected before induction of anaesthesia, during anaesthesia alone (normotensive or hypotensive), surgery with hypotension, and recovery. They were analysed for adrenocorticotropic hormone (ACTH), arginine vasopressin (AVP), cortisol and aldosterone.

trandate drug 2015-11-22

A cohort study with matched controls using a Cleocin Maximum Dose prospectively collected database.

trandate oral dose 2016-03-10

1 The pharmacokinetics of intravenously administered labetalol were studied in four patients with severe renal failure and in three normal subjects. 2 A new and sensitive method for the assay of plasma labetalol concentrations using high performance liquid chromatography is described. 3 Labetalol has a relatively large apparent volume of distribution (3.3-7.9 l/kg, two-compartment open model) and a relatively high plasma clearance (0.3-1.6 1 h-1 kg-1). 4 There were no significant differences between the patients with severe renal failure and the controls for any of the pharmacokinetic parameters measured. 5 In the Imdur Dosage presence of renal functional impairment, no modification of labetalol dosage is required. 6 In another study of 31 patients, glomerular filtration rate was measured at 3-month intervals for 3-18 months. In ten patients there was no change, in ten there was an improvement and in 11 there was deterioration, but in only three was this attributable to treatment. 7 In our experience with over 300 patients, we conclude that labetalol plus diuretic treatment is efficacious and safe in all grades of hypertension including those with all degrees of renal insufficiency.

5 mg trandate 2016-07-12

Labetalol reverses the cocaine-induced rise in mean Lopid Brand Name arterial pressure, but does not alleviate cocaine-induced coronary vasoconstriction.

trandate dose 2017-06-25

The purpose of the current experiment was to study the role of various adrenoceptor subtypes in the cardiovascular response to cocaine in conscious squirrel monkeys. A variety of adrenoceptor antagonists were administered i.v. prior to the administration of 0.3 mg/kg cocaine (i.v.). Cocaine alone produced an increase in both blood pressure and heart rate. The non-selective alpha adrenoceptor antagonist phentolamine produced a dose-dependent antagonism of the pressor effect of cocaine, as did the alpha-1 selective antagonist prazosin. The alpha-2 selective antagonist yohimbine had no effect on the pressor effect of cocaine. The non-selective beta antagonist propranolol enhanced the pressor effect Stromectol En Alcohol of cocaine as did the beta-1 selective antagonist atenolol. However, the effect of atenolol was not dose-dependent. The beta-2 selective antagonist ICI 118,551 and labetalol, which blocks both alpha and beta adrenoceptors, did not alter the pressor effect of cocaine. Propranolol, atenolol, and labetalol all antagonized the tachycardiac effect of cocaine in a dose-dependent manner, while the beta-2 antagonist ICI 118,551 did not. Phentolamine, prazosin and yohimbine also reduced the tachycardiac effect of cocaine, although these effects were dose-dependent only for yohimbine, which also significantly elevated baseline heart rate. These results indicate that alpha-1 adrenoceptor mechanisms mediate the pressor effect of cocaine, while beta-1 adrenoceptor mechanisms are involved in the tachycardiac effect of cocaine in squirrel monkeys. Propranolol potentiated cocaine's pressor effect through beta-2 independent mechanisms. Thus, neither alpha-2 nor beta-2 adrenoceptor mechanisms appear to be involved in cocaine's cardiovascular effects.

trandate reviews 2015-09-21

Primary: mean dBP at 28, 32 and 36 weeks. Secondary: clinician compliance and women's satisfaction. Brahmi Pills Other: serious perinatal and maternal complications.

trandate 200mg tablets 2016-04-08

Antihypertensive effects of labetalol and nifedipine were evaluated in a double blind cross over trial in ambulatory patients with moderately severe hypertension (mean diastolic BP 101.2 +/- 1.78 mm Hg, 105 +/- 2.15 mm Hg respectively and mean systolic BP 164.2 +/- 4.2 mm Hg and 171.4 +/- 5.82 mm Hg respectively in each group of 10 patients). The effect of labetalol over the systolic and diastolic BP was highly significant (p less than 0.01). The effects of nifedipine on systolic and diastolic BP were also significant but effects on diastolic BP was highly significant (p less than 0.01). In cross over study it was seen that nifedipine was not much superior in lowering the systolic BP whereas diastolic BP was lowered to a significant level (p less than 0.05) as compared to labetalol.

trandate overdose 2015-12-02

Diaspirin crosslinked hemoglobin (DCLHb) administration elevates mean arterial pressure (MAP). The purpose of this study was to determine whether commonly used antihypertensive agents could control this pressor effect in rats. Awake rats were injected intravenously (i.v.) with 280 mg/kg of DCLHb. Fifteen minutes later when MAP was 25-30% above baseline and heart rate (HR) was reciprocally decreased, prazosin (2 mg/kg;an alpha adrenergic blocker), nitroglycerine (NTG; 10-150 mcg/min; a nitrovasodilator), nicardipine (0.204-0.08 mg/hr; a calcium channel blocker) or labetalol (5 mg/kg; an alpha/beta adrenergic blocker) was administered i.v. All four classes of antihypertensive agents promptly restored MAP to baseline. Coincident with the return of MAP to baseline, HR was restored to baseline in prazosin and NTG treated animals, however, bradycardia persisted in those animals treated with nicardipine and labetalol, most likely due to the negative chronotropic properties of these agents. We conclude that the pressor effect of DCLHb can be readily controlled with at least four different classes of commonly used antihypertensive agents.

trandate usual dosage 2017-09-02

Endothelial Cx43 was reduced by 35% and Cx37 by 59% in hypertensive rats (P < .001). The reduction was recovered fully by carvedilol but only partially by atenolol (P < .05), although both drugs lowered the blood pressure to similar levels. Cx40 remained stationary in all groups. In HUVEC, carvedilol (10 microg/mL) increased Cx43 protein expression by >70% (P < .01), whereas other drugs had minimal effects. The upregulation by carvedilol was associated with increased transcripts and decreased proteolysis of Cx43.

trandate 300 mg 2015-05-26

The effects of metoclopramide, labetalol, and metoclopramide plus labetalol treatments on baseline cardiovascular parameters and isometric handgrip-induced changes were evaluated in 11 hypertensive subjects. Although all treatments were effective in reducing resting systolic (SBP) and diastolic (DBP) blood pressures, the combination of metoclopramide and labetalol appeared to provide a greater decrease (changes in SBP/DBP: 15/11 mm Hg, P < 0.05; from 149 +/- 4/95 +/- 4 mm Hg to 134 +/- 5/84 +/- 3 mm Hg) than did labetalol alone (changes in SBP/DBP: 10/9 mm Hg, P < 0.05; from 149 +/- 4/95 +/- 4 to 139 +/- 4/86 +/- 3 mm Hg). At 2 minutes, handgrip increased blood pressure on placebo (changes in SBP/DBP: 34/7 mm Hg, P < 0. 001). In the presence of metoclopramide and metoclopramide plus labetalol, however, handgrip induced lesser increases in blood pressure (changes in SBP/DBP: 23/7 mm Hg, P < 0.01, and 18/4 mm Hg, P < 0.01, for metoclopramide and metoclopramide plus labetalol treatments). We conclude that (1) metoclopramide lowers blood pressure in hypertensive patients; (2) metoclopramide attenuates blood pressure response to isometric handgrip; and (3) both compounds, labetalol and metoclopramide, seem to have a pharmacologic interaction concerning blood pressure decrease. A clinical significance is suggested for the metoclopramide effect.

trandate medicine 2015-05-08

This is the first reported case of labetolol induced hyperkalaemia in pregnancy, with life threatening consequences and hence all health professionals should be alert to this potential effect.

trandate 5 mg 2015-05-15

Hypertensive pregnant women who do not respond to treatment with labetalol to control blood pressure (BP), but require vasodilatory therapy, progress rapidly to severe hypertension. This could be delayed by early recognition and individualized treatment. In this study, we sought to create prediction models from data at presentation and at 1 h and 24 h after commencement of treatment to identify patients who will not have a sustained response to labetalol and therefore need vasodilatory therapy.

trandate pill 2015-05-19

The effects of intravenously administered labetalol on blood pressure and pulse rate were examined in 17 patients with severe hypertension. Prompt and sustained falls in supine blood pressure and pulse rate occurred in ten patients (responders), but seven patients showed little or no change in either measurement (non-responders). Labetalol had a more marked effect on standing than on supine blood pressure. Only two of the responders, but all of the non-responders were concurrently receiving antihypertensive drugs. Plasma renin activity, plasma renin concentration and plasma angiotensin II concentration fell slightly over the one-hour period of observation in ten patients in whom serial measurements were made, but the changes were independent of the blood pressure response.