(Deemed to be University)

(Accredited by NAAC with a CGPA3. 64 on a four- point scale at ‘A++’ grade)

DR. D.Y. PATIL COLLEGE OF NURSING PIMPRI, PUNE-18.

DRUG
PRESENTATION
ON LABETALOL

SUBMITTED TO: SUBMITTED BY:

MS. SUCHETA YANGAD Miss. LAXMI SINHA
(ASSOC.PROFFESOR) 1ST YEAR NPCC
DR D Y PATIL COLLEGE DR D Y PATIL COLLAGE
OF NURSING. OF NURSING.

SUBMITTED ON:
08/01/2025
❖ INTRODUCTION:
Labetalol is a unique antihypertensive medication that combines both alpha-
and beta-adrenergic receptor blocking properties. Introduced in the late 20th
century, it is a versatile drug used for the effective management of high
blood pressure in both acute and chronic settings. Its dual mechanism of
action makes it particularly useful in conditions requiring rapid blood
pressure reduction, such as hypertensive emergencies, and it is also widely
used in pregnancy-related hypertension like preeclampsia. Labetalol's safety
profile, combined with its efficacy, has established it as a cornerstone in
antihypertensive therapy across diverse clinical scenarios.

❖ DRUG OVERVIEW:
• Name: Labetalol

• Generic Name: Labetalol hydrochloride

• Drug Class: Combined alpha- and beta-adrenergic receptor blocker

• Brand Name(s): Trandate, Normodyne

• Route of Administration: Oral and intravenous (IV)

• Formulation: Tablets, injectable solution

❖ MECHANISM OF ACTION:

1. Beta-Adrenergic Receptor Blockade (Non-Selective)

Labetalol blocks β1 and β2 adrenergic receptors, resulting in:

• Reduced heart rate (negative chronotropic effect)

• Decreased myocardial contractility (negative inotropic effect)
• Suppression of renin release from the kidneys, leading to reduced
angiotensin II production and decreased blood pressure.

2. Alpha-1 Adrenergic Receptor Blockade

Labetalol also blocks α1 adrenergic receptors, which causes:

• Vasodilation of peripheral blood vessels, leading to decreased

systemic vascular resistance and reduced blood pressure.
 3. Dual Effects on Blood Pressure

• Alpha-1 blockade primarily reduces peripheral resistance

(afterload), while the beta blockade reduces cardiac output (by
lowering heart rate and contractility).
• This combined action lowers blood pressure without causing reflex
tachycardia (as the beta-blocking action inhibits the reflex increase in
heart rate).

Clinical Implications

• Labetalol is used for managing hypertension, particularly in

hypertensive emergencies and in conditions like preeclampsia or
eclampsia, due to its rapid onset of action when given intravenously.
• Its balanced adrenergic blockade provides effective blood pressure
reduction while minimizing side effects like excessive bradycardia or
significant orthostatic hypotension.

❖ USES:-
Labetalol is a non-selective beta-blocker with alpha-1 adrenergic blocking
properties. It is commonly used for managing cardiovascular conditions. Its
dual mechanism of action results in a reduction of blood pressure without
significant changes in heart rate.

1. Hypertension:
o Primary indication for chronic and acute hypertension.
o Used in hypertensive emergencies, including pregnancy-related
hypertension (e.g., preeclampsia).
2. Hypertensive Crises:
o Rapid control of blood pressure in hospital settings (intravenous
labetalol).
3. Pregnancy-Induced Hypertension (PIH):
o A preferred agent due to its relative safety during pregnancy.
4. Angina Pectoris and Coronary Artery Disease:
o Provides symptomatic relief in some cases of chest pain.
5. Heart Failure (off-label):
o Occasionally used in specific cases of chronic heart failure
under strict monitoring.
❖ ADMINISTRATION:

• Oral: Labetalol tablets are taken with or without food, typically in

divided doses.
• Intravenous (IV): Administered in hypertensive emergencies, either as a
slow IV bolus or continuous infusion.

❖ INDICATIONS:

1. Management of mild to severe hypertension.

2. Hypertensive urgency or emergency (IV form).
3. Hypertension during pregnancy (pre-eclampsia/eclampsia).
4. As adjunctive therapy in the management of pheochromocytoma-induced
hypertension.

❖ CONTRAINDICATIONS:

Labetalol should not be used in the following situations:

1. Absolute Contraindications:
o Asthma or other reactive airway diseases.
o Second- or third-degree heart block (in the absence of a
pacemaker).
o Cardiogenic shock.
o Severe bradycardia.
o Decompensated heart failure.
2. Relative Contraindications (use with caution):
o Chronic obstructive pulmonary disease (COPD).
o Peripheral vascular disease.
o Diabetes mellitus (may mask hypoglycemia symptoms).
o Renal or hepatic impairment.
o Concurrent use with other antihypertensive drugs that may
cause hypotension.
❖ DOSAGES:

Adult Dosage

1. Oral:
o Initial dose: 100 mg twice daily.
o Maintenance dose: 200–400 mg twice daily (adjust based on
response).
o Maximum dose: 2,400 mg/day in divided doses.
2. Intravenous (IV):
o Initial dose: 20 mg over 2 minutes.
o Titration: Additional 40–80 mg IV every 10 minutes, up to a
total of 300 mg.
o Continuous infusion: Start at 0.5–2 mg/min, adjust as needed.

Pediatric Dosage

• Oral: Limited data, individualized dosing.

• IV: 0.2–1 mg/kg as a single dose (max: 40 mg/dose) or continuous
infusion at 0.25–3 mg/kg/hr.

❖ PHARMACOKINETICS

1. Absorption:
a. Rapidly absorbed after oral administration; bioavailability ~25%
due to extensive first-pass metabolism.
2. Distribution:
a. Plasma protein binding: ~50%.
b. Volume of distribution: 5–7 L/kg.
3. Metabolism:
a. Hepatic metabolism primarily through glucuronidation.
4. Elimination:
a. Half-life: 5–8 hours.
b. Excretion: 55% in urine (as metabolites), 40% in feces.
❖ PHARMACODYNAMICS

1. Mechanism of Action:
o Beta-adrenergic blockade: Reduces heart rate and myocardial
contractility.
o Alpha-adrenergic blockade: Causes vasodilation, reducing
peripheral vascular resistance.
2. Effects on Blood Pressure:
o Lowers systolic and diastolic blood pressure without significant
reflex tachycardia.
3. Onset and Duration:
o Onset: Oral (2 hours), IV (5–10 minutes).
o Duration: Oral (8–12 hours), IV (2–6 hours).

❖ SIDE EFFECT:
Common Side Effects:

• Dizziness
• Fatigue
• Nausea
• Orthostatic hypotension
• Scalp tingling

Serious Side Effects:

• Bradycardia
• Heart block
• Bronchospasm (caution in asthma)
• Hepatotoxicity
• Hypoglycemia (in diabetics)

Rare Side Effects:

• Skin rash
• Lupus-like syndrome
❖ NURSES RESPONSIBILITY:
Nurses play a critical role in the administration and monitoring of labetalol, a
medication commonly used to manage hypertension and heart conditions
such as acute hypertensive crises. Their responsibilities include:

1. Assessment:
o Nurses must assess the patient's blood pressure, heart rate, and
overall cardiovascular status before administering labetalol.
This helps ensure that the drug is suitable for the patient and
that it will not cause harm due to existing conditions such as
bradycardia or hypotension.
2. Administration:
o Labetalol can be administered orally or intravenously,
depending on the clinical situation. Nurses must follow the
prescribed route and dosage, being mindful of the drug's
potential to lower blood pressure and heart rate. Intravenous
administration requires careful monitoring to avoid rapid drops
in blood pressure.
3. Monitoring:
o After administering labetalol, nurses are responsible for
continuous monitoring of vital signs (blood pressure and heart
rate) to ensure the medication's effects are appropriate. Special
attention should be paid to signs of bradycardia, hypotension, or
other adverse reactions.
o They should also observe for common side effects such as
dizziness, fatigue, or headaches, and promptly report any
concerning symptoms to the healthcare provider.
4. Patient Education:
o Nurses should educate patients on the importance of adhering to
their prescribed labetalol regimen and what to expect during
treatment. Patients should be informed about the signs of low
blood pressure and what actions to take if they feel lightheaded
or dizzy.
o Additionally, nurses should educate patients about lifestyle
modifications, such as reducing salt intake and engaging in
regular physical activity, to complement the medication’s
effects.
5. Documentation:
o Accurate documentation is vital for tracking the patient's
response to labetalol. Nurses should record vital signs, any side
effects observed, and the time and dosage of medication
o administration in the patient’s medical chart.
❖ CONCLUSION
Labetalol is an effective medication for controlling high blood pressure and
preventing hypertensive crises. However, its administration requires careful
nursing attention to ensure patient safety and effective therapeutic outcomes.
Nurses are essential in monitoring the patient's response to the drug,
educating them about proper usage, and preventing potential adverse effects.
Their comprehensive involvement ensures that labetalol achieves its desired
effects without causing undue harm.

❖ REFERENCES
1. Vallerand, A. H., & Sanoski, C. A. (2020). Drug Guide for Nurses
(15th ed.). Elsevier.
2. Hickey, J. V. (2019). The Clinical Practice of Neurological and
Neurosurgical Nursing (7th ed.). Lippincott Williams & Wilkins.
3. Sloand, J. A., & Jone, E. (2021). Pharmacology for Nursing Care (9th
ed.). Elsevier.
4. Tisdale, J. E., & Miller, D. A. (2019). Pharmacotherapy: A
Pathophysiologic Approach (11th ed.). McGraw-Hill.
5. American Heart Association (2023). Hypertension Treatment and
Management. Retrieved from https://www.heart.org.