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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:
Albetol, Ascool, Biascor, Hybloc, Ibidomide, Ipolab, Labetaloli, Labetalolo, Labetalolum, Normadate, Normodyne, Normozide, Presolol, Resporito

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Sectral , Tenormin , Coreg , Lopressor , Toprol , Corgard , Inderal

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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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The role of combined alpha and beta blockade as a means of limiting infarct size has been studied in a randomised controlled trial using labetalol. Only 166 of 630 (26%) consecutive patients admitted to a cardiac care unit with suspected myocardial infarction were deemed suitable for inclusion; most of the remainder had delayed admission to hospital, were over the age limit of 75, or had complications which precluded the use of labetalol. Those on active treatment received a loading dose followed by a slow intravenous infusion over six hours, and oral therapy for the subsequent five days. Doses were adjusted to maintain systolic pressure in the range 100 to 120 mmHg. The control group received only conventional therapy. Labetalol caused lowering of the blood pressure and heart rate during the phase of intravenous treatment, but little effect occurred subsequently because oral dosage was constrained by low systolic pressures. The group that received active treatment had significantly greater release of CKMB enzyme. Little difference was observed in R wave scores or ejection fraction. Only low doses of labetalol can be used for most patients with acute myocardial infarction. Labetalol cannot be recommended as routine treatment for normotensive patients admitted to hospital with suspected infarction.

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The authors recently reported the increased oral clearance of labetalol in pregnant women. To elucidate the mechanism of the elevated oral clearance, it was hypothesized that female hormones, at the high concentrations attainable during pregnancy, enhance hepatic metabolism of labetalol. Labetalol glucuronidation, which is the major elimination pathway of labetalol, was characterized by screening six recombinant human UGTs (UGT1A1, 1A4, 1A6, 1A9, 2B4, and 2B7) for their capacity to catalyse labetalol glucuronidation. The effect of female hormones (progesterone, oestradiol, oestriol, or oestrone) on the promoter activities of relevant UDP glucuronosyltransferases (UGT) was investigated using a luciferase reporter assay in HepG2 cells. The involvement of oestrogen receptor alpha (ERalpha) and pregnane X receptor (PXR) was examined by co-transfecting ERalpha- or PXR-constructs. UGT1A1 and UGT2B7 were identified as the major UGT enzymes producing labetalol glucuronides (trace amount of glucuronide conjugate was formed by UGT1A9). The activities of the UGT1A1 promoter containing PXR response elements were enhanced by progesterone, but not by oestrogens, indicating PXR-mediated induction of UGT1A1 promoter activity by progesterone. Results from semi-quantitative real-time polymerase chain reaction (PCR) assays are consistent with the above findings. This effect of progesterone on UGT1A1 promoter activities was concentration dependent. Promoter activities of UGT2B7 were not affected by either oestrogens or progesterone. The results suggest a potential role for progesterone in regulating labetalol elimination by modulating the expression of UGT1A1, leading to enhanced drug metabolism during pregnancy.

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Acute blood pressure elevations are commonly treated in hospitalized patients. There are no guidelines for appropriate practice and no evidence that such treatment is useful. The authors performed a retrospective review of medical and pharmacy records to determine how often intravenous hydralazine and labetalol are ordered and administered. During a 1-year study period, a total of 29,545 hospitalizations were recorded. The authors identified 2189 patients (7.4% of all patients) for whom 7242 orders were written for hydralazine as needed (10-20 mg per dose) and 5915 for labetalol (10-20 mg per dose). Ordered drugs were administered in 60.3% of patients, and the average number of doses administered was 5.3+/-8.2 (mean +/- SD) for hydralazine and 5.6+/-7.7 for labetalol. Hospital length of stay (LOS) for patients for whom hydralazine was ordered was 12.0+/-15.9 days for those who received at least 1 dose and 7.1+/-9.0 days for those who did not receive a dose (P<.001). For patients for whom labetalol was ordered, patients receiving at least 1 dose had an LOS of 11.8+/-16.1 days vs 7.9+/-10.4 days for those who did not receive a dose (P<.001). Treatment of elevated blood pressure in in-patients is a common practice. The authors suggest that evidence is needed to determine whether the practice is of benefit.

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Labetalol represents the culmination of an effort to enhance the antihypertensive efficacy and to improve the hemodynamic profile of beta-adrenoceptor blockers by incorporating an additional anti-hypertensive action, that is, alpha blockade, into its pharmacologic mechanism. Reviewed here are the major aspects of the animal pharmacology of labetalol. The compound blocks beta1 and beta2-adrenoceptors nonselectively. Its blockade of alpha receptors is selective and directed at the alpha1 subset. Labetalol also dilates blood vessels independently of these mechanisms. This action is mediated by activation of vascular beta2 adrenoceptors. Thus, labetalol acts as a partial agonist on vascular smooth muscle. However, it differs markedly from other beta blockers with intrinsic sympathomimetic activity in that its agonism is directed specifically at beta2 receptors. Labetalol lowers blood pressure in a variety of animal models of hypertension. Unlike pure beta blockers, the compound reduces peripheral vascular resistance. On the basis of this profile, it is proposed that labetalol lowers blood pressure in human subjects by three independent mechanisms: (1) beta blockade, (2) alpha blockade, and (3) direct vasodilatation.

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The authors report a case of unruptured subcapsular haematoma of the liver in a 31-year-old woman, para 2, in the 34th week of pregnancy, complicated by preeclampsia. Clinical signs of preeclampsia were associated with pain in the right hypocondrium and laboratory findings consistent with a true HELLP syndrome. The diagnosis of subcapsular haematoma was confirmed by tomodensimetry. A cesarean section was carried out but a conservative treatment of the hepatic haematoma was decided. Regular X-ray follow-ups showed the regression of the hepatic lesion. This case confirms recent reports that patients with unruptured capsular haematoma should be treated conservatively but should receive careful monitoring.

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The effects of prazosin, labetalol, and medroxalol were studied in the rabbit sino-atrial node, Purkinje cells and papillary muscles. At concentrations producing similar bradycardia, labetalol and medroxalol reduced the maximum rate of depolarization (Vmax) and overshoot potential in the sinus node. Prazosin had no such effects. These large and highly significant reductions in Vmax and overshoot in sinus node cells were observed at concentrations of medroxalol and labetalol which had no negative inotropic effect. If depolarization in the sinus node was due to the second inward current, this would imply that such currents in the sinus node and contracting cardiac muscle are pharmacologically distinct. All three drugs prolonged action potential duration in the sinus node, Purkinje cells and papillary muscles in a dose-related manner. Recovery after 1 h in drug-free solution from the effects of medroxalol and labetalol was only partial in the sinus node, but almost complete in Purkinje cells and papillary muscle. Recovery from prazosin was complete in all tissues. All three drugs depressed Vmax in Purkinje cells and papillary muscles in a dose-related manner, and recovery was complete. It is concluded that all three drugs had class 1 and class 3 antiarrhythmic actions, which could contribute to their protective effects in ischaemia and reperfusion independently of blockade of myocardial alpha-adrenoceptors.

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A retrospective review was undertaken among children with hypertensive emergency admitted in our tertiary children hospital between June 2014 and December 2015 with an aim to identify any children with HHS. Three children with HHS were identified during this period.

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1 The effects of alpha-adrenoceptor agonists and antagonists on contractile responses of transmurally stimulated prostatic and epididymal portions of the rat isolated vas deferens were examined. 2 Responses to single stimuli consisted of two phases, the first predominant in the prostatic and the second in the epididymal portion. The first phase was resistant to alpha-adrenoceptor antagonists but the second was reduced in a dose-related manner in the order of potency prazosin greater than azapetine greater than phentolamine greater than labetalol greater than yohimbine. 3 Both phases of the response to a single stimulus were reduced by clonidine but only the first could be reliably restored by yohimbine. 4 Trains of transmural stimuli produced biphasic responses, an early rapid component predominant in the prostatic and a slow secondary component predominant in the epididymal portion. The effects of alpha-adrenoceptor antagonists on these responses were complex. Prazosin produced the most straightforward inhibition of responses with relative resistance of the early rapid component. Only yohimbine and phentolamine produced increases in responses which could be pre-junctional in origin. 5 The alpha-adrenoceptor agonists, oxymetazoline and clonidine, reduced while phenylephrine increased responses to trains of stimuli. 6 These results are discussed in relation to the nature of the innervation of rat vas deferens and the usefulness of the preparation in pharmacological tests for activity at alpha-adrenoceptors.

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The effect of long-term treatment with propranolol (45 patients), trasicor (15), visken (23) and combinations thereof with phentolamine and labetalol (12) on submaximum exercise tolerance was studied in patients with second-stage essential hypertension. Beta-adrenoblockers had no effect on total systemic oxygen consumption, but reduced significantly its myocardial consumption and brought down systolic and diastolic arterial blood pressure at rest and during exercise. Differences were demonstrated in the hemodynamic mechanism of the decline in resting arterial pressure: under the effect of propranolol and trasicor, peripheral resistance increased insufficiently in response to a fall of the cardiac index; visken and labetalol depressed peripheral resistance without affecting the cardiac index. During exercise, all 4 beta-adrenoblockers reduced the cardiac index, mainly at the expense of a smaller pulse rate. An additional hypotensive effect of phentolamine that owes to reduced peripheral resistance was demonstrated.

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We report the case of a 47-year-old woman with Guillain-Barré syndrome who developed autonomic instability and hypertension and subsequently developed a subarachnoid haemorrhage. This was manifested clinically by a seizure which began focally and became generalised. Computer tomography demonstrated a localised haemorrhage in the left central sulcus. Control of the hypertension was achieved with intravenous labetolol. Autonomic instability and hypertension are frequently reported in Guillain-Barré syndrome. Subarachnoid haemorrhage is an uncommon but serious complication.

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trandate cost 2015-08-13

The effects of single oral doses of indoramin (mean dose 58 mg), abetalol (mean dose 150 mg), alinidine 80 mg and placebo on arterial pressure and heart rate in the supine and standing positions were studied in six normal volunteers. Doses were chosen to give equivalent reductions of arterial pressure in the standing position. Observations were made before and at 2 and 4 h after drug administration. Plasma noradrenaline (NA) was measured at each time interval in the supine position, and after 4 min of standing. Plasma renin activity (PRA) was measured at each time interval after 30 min in the standing position. In the supine position, alinidine produced a significant reduction of systolic arterial pressure from 124.0 +/- 3.0 mm Hg to 104.3 +/- 4.1 mm Hg at 2 h (P less than 0.01) and to 101.7 +/- Crestor 20mg Cost 2.2 mm Hg at 4 h (P less than 0.01). Diastolic pressure was reduced from 74.7 +/- 2.6 mm Hg to 57.0 +/- 4.6 mm Hg at 4 h (P less than 0.01). Arterial pressure was unchanged after indoramin or labetalol administration. In the supine position, heart rate was unchanged after indoramin, and small reductions were observed after labetalol and alinidine. Indoramin produced a significant increase in plasma NA. A small increase of plasma NA was observed after labetalol, and a small decrease after alinidine. In the standing position, the three active drugs reduced systolic arterial pressure to a similar extent (indoramin, -26.7 mm Hg at 4 h after drug administration; labetalol, -21.3 mm Hg at 2 h; alinidine, -21.7 mm Hg at 4 h).(ABSTRACT TRUNCATED AT 250 WORDS)

trandate generic name 2017-10-24

Rats premedicated with azelnidipine (0.3 mg/kg), labetalol (3 mg/kg), or vehicle, were restrained for 30 min (immobilization stress: IMO) to reproduce emotional stress, and anesthetized to release stress. We measured the fractional area change (FAC) by echocardiography, blood pressure, and heart rate at the end of IMO and every 10 min for 60 min after IMO. During IMO, FAC in the labetalol group was significantly lower than that in the other two groups. At 20 min Celebrex Cost Walgreens after IMO, FAC in the azelnidipine or labetalol group was significantly higher than that in the vehicle group (86 ± 9%, 73 ± 5% vs. 56 ± 11%, p<0.05). During IMO, mean blood pressure in the azelnidipine or labetalol group was significantly lower than that in the vehicle group (107 ± 5 mmHg, 106 ± 17 mmHg vs. 124 ± 5 mmHg, p<0.05).

trandate generic 2015-01-03

The prevalence of hypertension in children is of the order of 1%-3%. Of these children, 10% will have Prandin Generic Price severe hypertension and in the majority the increased blood pressure will be secondary to renal disease. Nephrologically orientated investigation is therefore important. The most helpful investigations are: peripheral plasma-renin activity, 99mTc dimercaptosuccinic acid (DMSA) scan, main and segmental renal vein renin measurements and renal angiography plus 123I metaiodobenzyl guanidine (MIBG) scan in suspected phaeochromocytoma. Drug treatment of accelerated hypertension is most successfully undertaken by intravenous labetalol or sodium nitroprusside; sustained moderate-to-severe hypertension by a beta-blocker plus a vasodilator or an angiotensin-converting enzyme inhibitor with or without a diuretic; mild hypertension by diet, diuretic and if necessary by more powerful hypotensives. Surgical treatment by revascularization or nephrectomy and percutaneous transluminal angioplasty can be successful. Utilizing the current range of investigational and therapeutic tools the aetiology and appropriate management of hypertension can be effectively and safely undertaken in the majority of hypertensive children.

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Of the 70 participants; Zithromax Online Pharmacy 24% developed superimposed preeclampsia (SPE), and there was a 19% incidence of SGA-3 (GROW customised birthweight below the third percentile).

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How Canadian practitioners are managing the hypertensive disorders of pregnancy (HDP) is not known Propecia Cost Cvs , particularly in relation to the 1997 guidelines published by the Canadian Hypertension Society (CHS).

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A combined approach of clinical assessment and angiographic assessment of venous drainage, using intravenous labetalol for hypotensive challenge, is effective in screening out patients who were at a risk Antabuse Drug Cost for ischaemia after internal carotid artery occlusion and can serve as a guideline for the selection of patients requiring extracranial-intracranial bypass.

trandate cost 2015-11-14

In a randomized cross-over trial the combination labetalol/hydrochlorothiazide was compared with the combination of propranolol/hydralazine/hydrochlorothiazide in 34 uncomplicated hypertensive patients, who were not satisfactorily controlled with hydrochlorothiazide 50 mg alone. The elevated diastolic pressure (D.P.) in 27 patients responded satisfactorily to the labetalol schedule and in 28 patients to the propranolol/hydralazine schedule. No difference was found in the rate of decrease of D.P., nor in the disappearance of hypertension-related complaints. Although the duration of the washout between treatments was at least one month, treatment was significantly more efficacious during the second period. Labetalol pre-treatment especially seemed to enhance the effect of subsequent propranolol/hydralazine administration. Side effects due to therapy were rare and were not related to any Diovan Generic Manufacturers particular treatment. The median daily dose of labetalol in responders was 600 mg and that of propranolol/hydralazine 120/60 mg (in both therapies hydrochlorothiazide 50 mg was given in addition). Patients showed a slight preference for the labetalol medication. It is concluded that labetalol/hydrochlorothiazide and propranolol/hydralazine/hydrochlorothiazide are equally satisfactory in the treatment of uncomplicated hypertension.

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Both agents appear equally effective and safe for Generic Zanaflex Pictures blood pressure control in SAH and ICH during the initial admission hours. A prospective study is needed to validate these findings.

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Hypocapnia before Combivir Generic Equivalent and during carbon dioxide (CO(2)) insufflation for laparoscopic cholecystectomy may reduce the adverse hemodynamic responses.

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Two hundred fifty-five patients were evaluated for inclusion, and 36 patients (19 women and 17 men; mean age, 44 years; age range, 23 to 67 years) were studied. The most frequent reason for exclusion was a spontaneous decrease in diastolic blood pressure to less than 110 mm Hg (31%) with bedrest. There were 12 patients in each treatment group. Compared with baseline, the 100-mg dose significantly (P less than .05) reduced heart rate at three and four hours after dose, and the 300-mg dose significantly (P less than .05) reduced heart rate at one, two, and three hours after dose; the 200-mg dose did not significantly affect heart rate. All doses produced a significant decrease in systolic and diastolic blood pressures at one, two, three, and four hours after dose compared with baseline. There were no statistically significant differences between treatment groups with regard to systolic or diastolic blood pressure or heart rate at baseline or one, two, three, or four hours after dose. At two hours after dose, diastolic blood pressure control was observed in 75%, 58%, and 67% of patients receiving 100, 200, and 300 mg, respectively (P = .903). At four hours after dose, diastolic blood pressure control was observed in 50%, 64%, and 67% of patients receiving 100, 200, and 300 mg, respectively (P = .755). A comparison of treatment success rates between the two time periods Ventolin Cost showed a waning of response with the 100-mg dose of labetalol at hour 4 compared with hour 2 (P less than .05). No adverse effects were observed.

trandate generic name 2017-09-03

Autonomic dysreflexia (AD) is a sudden and exaggerated autonomic response Asacol Generic Date to stimuli in patients with spinal cord injuries or dysfunction above the splanchnic sympathetic outflow (T5-T6). Hypertension is a relatively common manifestation of AD.