A 49-year-old male had erythematous to rusky red papules, indurated plaques and lichenified patches with hyperpigmentation on sun-exposed areas for 6 years. Phototest revealed the decreased rninimal erythemal dose to UVA(10J/cm. Photopatch test with 5% Trandate ointment, 5% hydrochlorthiazide ointment and vaselin. as a control were all negative. Two weeks after cessation of Trandate, an oral challenge of hydrochlorthiazide followed by phototest was perfrirmed resulting in exacerbation of skin lesions and photosensitivity with a decreased MED to UVA(10J/cm) again. After the cesation of Trandate containing hydrochlorthiazide, the skin lesions were improved with complete loss of photosensitivity. But, improvement of the infiltrated or licheified plaques were delayed. Presenile cataract previously noted in the patient seemed to be related to his longstanding intake of hydrochlorthiazide.
Cataract ; Humans ; Hyperpigmentation ; Labetalol ; Male ; Middle Aged ; Skin

The antihypertensive effect of labetalol was evaluated in 25 cases of essential hypertension. 1. Age distribution was from 38 to 71 years. Thirteen cases were female and 12 cases were male. 2. The daily effective doses were ranged from 300 to 600mg. Total duration of medication were from 1 week to 12 weeks(mean 5 wks). 3. The 10 cases of 25 showed good antihypertensive effect, and 9(36%) showed fair. In 76% of the cases showed effective antihypertensive effect. 4. Two cases were suffered from side effects, such as mild orthostatic hypotension and dizziness.
Age Distribution ; Dizziness ; Female ; Humans ; Hypertension ; Hypotension, Orthostatic ; Labetalol ; Male

Arterial blood pressure, pulse rate and rate pressure product changes following tracheal intubation were studied in 50 patients undergoing elective surgical procedures who received a thiopental-succinylcholine anesthetic intubation sequence. Three treatment groups and a control group were observed. Intravenous labetalol doses of 0.25 mg/kg, 0.5 mg/kg and 1.0 mg/kg, injected prior to anesthesia, were compared with respect to their effect on the cardiovascular sequences to direct laryngoscopy followed by the passage of an endotraeheal tube. The increases in heart rate and rate-pressure product associated with tracheal intubation were significantly prevented in labetalol treated patients, significantly. The increase in arterial pressure was prevented, insignificantly. However, it was dose-dependent. From the above result, a pre-induction dose of labetalol was effective in attenuating the pressure response to laryngoscopy and intubation.
Anesthesia ; Arterial Pressure ; Heart Rate ; Humans ; Intubation ; Intubation, Intratracheal* ; Labetalol* ; Laryngoscopy* ; Surgical Procedures, Elective

1) The effects of various alpha-adrenoceptor antagonists on the pressor responses to norepinephrine and phenylephrine were examined in anesthetized rabbits in an attempt to determine whether alpha1 and alpha2-adrenoceptors are located on vascular smooth muscle. 2) yohimbine and piperoxan caused a much greater reduction in the pressor responses(rise of 30~50mmHg) to norepinephrine than to phenylephrine, where as labetalol, thymoxamine, phentolamine and prazosin showed a much greater selectively in reducing the pressor responses to phnylephrine than to norepinephrine. 3) The prssor action of small dose of norepinephrine(rise of 10~20mmHg) was not significantly inhibited by the doses of labetalol, thymoxamine and prazosin which caused marked reduction of the above phenylephrine pressor responses, but yohimbine, piperoxan and phentolamine weakend the action significantly. 4) The results suggest that there are two types, alpha 1 and alpha 2, of postsynaptic alpha-adrenoceptors in the vasculature of rabbits. It seems that phenylephrine produces pressor responses by acting alpha 1-type adrenoreceptors: small doses of norepinephrine by acting on alpha 2-type: large doses of norepinephrine by acting on both types.
Labetalol ; Moxisylyte ; Muscle, Smooth, Vascular ; Norepinephrine* ; Phentolamine ; Phenylephrine* ; Piperoxan ; Prazosin ; Rabbits ; Yohimbine

The effect of labetalol on induced hypotension was studied in 13 patients undergoing major spine surgery. Hypotension was induced with initial dose of labetalol 0.4 mg/kg i.v. followed by 0.01 mg/kg/min i.v.infusion. BP, HR, and CVP were measured before, during, and after hypotension. Anesthesia was maintained with isoflurane (0.5-2 vol%) and N2O in 50% O2 supplemented by pancuronium. The time to systolic BP 75-85 mmHg or mean BP 55-65 mmHg was 18.5+/-2.8min and the time for systolic BP to recover 90% of prehypotensive value was 45.5+/-4.2 min. Heart rate was reduced signiTicantly after hypotension but remained stable at 80-90 beats/min thereafter. Central venous pressure showed no significant change irrespective of hypotension. The results suggest that combined use of fentanyl with labetalol or disuse of pancumnium may reduce the required dose of labetalol.
Anesthesia ; Central Venous Pressure ; Fentanyl ; Heart Rate ; Humans ; Hypotension* ; Isoflurane ; Labetalol* ; Pancuronium ; Spine*

BACKGROUND: BNP and NT-proBNP are very useful predictor of perioperative cardiac events. The authors therefore performed a retrospective study about the relationship between NT-proBNP and intraoperative hemodynamic stability. METHODS: The authors reviewed the chart of 126 patients which were consulted to cardiologists for preoperative cardiac evaluation from 2005 through 2007. All patients were divided into two groups; N-group (NT-proBNP < 300 pg/ml, n = 66) and H-group (NT-proBNP > or = 300 pg/ml, n = 60). The kinds of hemodynamic drugs and dosage and infusion time were calculated. Total amounts of hemodynamic drugs are scored by two methods. Infusion drugs were scored 30 points, bolus drugs (esmolol 30 mg, labetalol 10 mg, phenylephrine 50microg, ephedrine 10 mg, atropine 0.25 mg, nicardipine 0.5 mg) and preclusive nitroglycerin infusion were scored 5 points. Drug score is total sum of all scores. We compared the drug score of two groups. In addition, bivariate and partial correlation analysis were performed for the correlation of drug score. RESULTS: H-group showed a high (P = 0.029) drug score (17.68 +/- 21.78) more than N-group (10.13 +/- 15.79). H-group showed a low (P = 0.000) ejection fraction (51.69 +/- 12.90%) more than N-group (61.80 +/- 7.84%). But, only age (R: 0.234, P: 0.023) and ejection fraction (R: -0.222, P: 0.032) were correlated with drug score by partial correlation analysis. CONCLUSIONS: Patients with preoperative high NT-proBNP had decreased systolic function and demanded more hemodynamic drugs during noncardiac surgery. But, NT-proBNP was not correlated with drug score in itself.
Atropine ; Ephedrine ; Hemodynamics ; Humans ; Labetalol ; Natriuretic Peptide, Brain ; Nicardipine ; Nitroglycerin ; Peptide Fragments ; Phenylephrine ; Retrospective Studies

Controlled hypotension has been used to facilitate the surgical procedure and to reduce blood loss. This study was performed to compare the change of the cardiovascular systerm and intracranial pressure following the controlled hypotension induced by isoflurane, sodium nitroprusside, and labetalol in 28 cats. The results were as follows. 1) Heart rate was decreased with the isoflurane-induced hypotension, increased with the sodium nitroprusside-mduced hypotension. Both were not significant, but labetalol-induced hypotension increased heart rate significantly(P< 0.05). 2) Intracranial pressure was increased with isoflurane, sodium nitroprusside, and labetalol-induced hypotension significantly(P< 0.05), but there was significantly small per cent ehange in labetalol-induced hypotension than sodium nitroprusside-induced hypotension(P< 0.05). 3) Cerebral perfusion pressure was decreased with isoflurane, sodium nitroprusside, and labetalol-induced hypotension significantly(P< 0.01), but there was significantly small per cent change in labetalol-induced hypotension than isoflurane or sodium nitroprusside-induced hypotension(P < 0.01, P< 0.001).
Animals ; Cats* ; Heart Rate ; Hypotension* ; Hypotension, Controlled ; Intracranial Pressure ; Isoflurane* ; Labetalol ; Nitroprusside* ; Perfusion ; Sodium*

Controlled hypotension has been used to facilitate the surgical procedure and to reduce blood loss. This study was performed to compare the change of the cardiovascular systerm and intracranial pressure following the controlled hypotension induced by isoflurane, sodium nitroprusside, and labetalol in 28 cats. The results were as follows. 1) Heart rate was decreased with the isoflurane-induced hypotension, increased with the sodium nitroprusside-mduced hypotension. Both were not significant, but labetalol-induced hypotension increased heart rate significantly(P< 0.05). 2) Intracranial pressure was increased with isoflurane, sodium nitroprusside, and labetalol-induced hypotension significantly(P< 0.05), but there was significantly small per cent ehange in labetalol-induced hypotension than sodium nitroprusside-induced hypotension(P< 0.05). 3) Cerebral perfusion pressure was decreased with isoflurane, sodium nitroprusside, and labetalol-induced hypotension significantly(P< 0.01), but there was significantly small per cent change in labetalol-induced hypotension than isoflurane or sodium nitroprusside-induced hypotension(P < 0.01, P< 0.001).
Animals ; Cats* ; Heart Rate ; Hypotension* ; Hypotension, Controlled ; Intracranial Pressure ; Isoflurane* ; Labetalol ; Nitroprusside* ; Perfusion ; Sodium*

β Blockers such as propranolol and labetalol are known to induce toxic myopathy because of their partial β₂ adrenoceptor agonistic effect. Nebivolol has the highest β1 receptor affinity among β blockers, and it has never been reported to induce rhabdomyolysis until now. We report a patient who developed rhabdomyolysis after changing medication to nebivolol. A 75-year-old woman was admitted to our hospital because of generalized weakness originating 2 weeks before visiting. Approximately 1 month before her admission, her medication was changed from carvedilol 12.5 mg to nebivolol 5 mg. Over this time span, she had no other lifestyle changes causing rhabdomyolysis. Her blood chemistry and whole body bone scan indicated rhabdomyolysis. We considered newly prescribed nebivolol as a causal agent. She was prescribed carvedilol 12.5 mg, which she was previously taking, instead of nebivolol. She was treated by hydration and urine alkalization. She had fully recovered and was discharged.
Aged ; Chemistry ; Female ; Humans ; Labetalol ; Life Style ; Muscular Diseases ; Nebivolol* ; Propranolol ; Rhabdomyolysis*

Hypotensive anesthesia is still widely employed during neurosurgery in spite of the development of microsurgical techniques. There have been a few reports regarding cerebral blood flow during injections of labetalol, a non-selective beta and selective alpha 1-blocker, to control blood pressure during or after craniotomy and results were favorable. In 4 cases, intermittent labetalol injections were given for hypotensive anesthesia during clipping of a cerebral aneurysm and the results were as follows: 1) The onset was within 1-2 minutes after injection. 2) Hypotensive anesthesia was well maintained by repeated injections during surgery. 3) Systolic and mean arterial blood pressure were decreased as much as 35.7 mmHg and 24.3 mmHg respectively. 4) Heart rate did not change significantly. 5) After clipping, blood pressure returned to the previous level with atorpine or ephedrine. 6) We conclude that labetalol can be an excellent choice for hypotensive anesthesia.
Anesthesia* ; Arterial Pressure ; Blood Pressure ; Craniotomy ; Ephedrine ; Heart Rate ; Hypotension, Controlled ; Intracranial Aneurysm* ; Labetalol* ; Neurosurgery