Question | Answer |
Alpha blockade predominates so they are less likely to cause | significant reductions in HR and CO |
Two drugs in this category: | carvedilol[Coreg], labetalol[Normodyne] |
They combine | selective alpha 1 and nonselective beta |
They decrease BP | standing BP is more affected than supine |
They decrease myocardial oxygen demand | and lower cardiac workload |
single dose of labetolol has no effect on | sinus rate, intraventricular conduction or qrs duration |
no significant effect on serum | lipoproteins |
Contraindicated in pts with | bronchospastic component, overt NYHA class IV HF, greater than first degree block,and severe bradycardia |
Coreg has been shown to be effective in class II and III HF b/c of its | limited effects on HR, myocardial contractility, while improving hemodynamics and cardiac performance |
similar to cautions of BBs in | diabetes and thyroid disease, hepatic impairment |
risk for orthostatic hypotension higher than with | beta blockers |
Lab tests affected by labetolol | reversible increase in transaminases, and BUN, false + for amphetamines |
used to treat essential HTN | alone or in combination with thiazides. dose adjustments based on standing BP |
use in CHF tx: | Coreg in class II, III HF of ischemic or cardiomyopathy origin inconjunction with diuretics and ACEIs to reduce progression of disease and increase survival [not recommended in all guidelines] |
labetolol has been use to tx withdrawal HTN associated with | clonidine |
these drugs must be tapered when discontinued | just like alphas and betas used seperately |
labetolol may be used when a pt cannot tolerate changes in HR but needs | beta blockade [post MI prophylaxis] |