Tuesday December 9, 2008

Q: 52 year old male with history of End Stage Renal Disease (ESRD) - is admitted at 12 midnight with fluid overload, hypertensive crisis and mild hyperkalemia after he missed his dialysis session. Patient required intubation for hypoxemia but now saturating 100% on ventilator. Nephrology service informed you that it will take atleast 4 hours before hemodialysis can be arranged. Why Labetolol would be a bad choice for control of hypertension?

A: Labetolol may make hyperkalemia worse

Intravenous labetolol, a nonselective α- and β-blocking drug, is commonly used to treat severe hypertension but it can cause hyperkalemia. In patients with renal failure, it can be life-threatening, particularly in situations where emergent hemodialysis is not available.

Reference:

Life-Threatening Hyperkalemia after Intravenous Labetolol Injection for Hypertensive Emergency in a Hemodialysis Patient - Am J Nephrol 2001;21:241-244