Your doctor may occasionally change your dose to make sure you get the best results. Do not use this medicine in larger or smaller amounts or for longer than recommended.
Your blood pressure will need to be checked often, and you may need frequent medical tests at your doctor's office. If you need surgery, tell the surgeon ahead of time that you are using labetalol. Do not skip doses or stop taking labetalol without first talking to your doctor.
Stopping suddenly may make your condition worse. Labetalol can cause false results with certain lab tests of the urine. Tell any doctor who treats you that you are using labetalol. Taking labetalol can make it harder for you to tell when your blood sugar is low. If you have diabetes, check your blood sugar regularly.
Keep using this medicine as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.
Store at room temperature away from moisture and heat. Labetalol is only part of a complete program of treatment for hypertension that may also include diet, exercise, weight control, and other medications. Follow your diet, medication, and exercise routines very closely. What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if your next dose is less than 8 hours away. Do not take extra medicine to make up the missed dose. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at Overdose symptoms may include slow heart rate , extreme dizziness , or fainting.
To minimize the risk of dislodging the catheter, veins in the hands and in the vicinity of joints eg, antecubital should be avoided. Veins in the forearm ie, basilic, cephalic, and median antebrachial are usually good options for peripheral infusions. Prior to drug administration, the patency of the I. The line should be flushed with mL of a saline or dextrose solution and the drug s infused through the side of a free-flowing isotonic saline or dextrose infusion.
A frequently recommended precaution against drug extravasation is the use of a central venous catheter. Use of a central line has several advantages, including high patient satisfaction, reliable venous access, high flow rates, and rapid dilution of the drug. A wide variety of devices are readily available. Many institutions encourage or require use of a vascular access device for administration of vesicant agents.
Despite their benefit, central lines are not an absolute solution. Vascular access devices are subject to a number of complications. Additionally, these catheters require routine care to maintain patency and avoid infections.
Finally, extravasation of drugs from venous access devices is possible. Reports of extravasation from central catheters range from 0. When a drug extravasation does occur, a variety of immediate actions have been recommended.
Although there is considerable uncertainty regarding the value of some potential treatments, a few initial steps seem to be generally accepted. At the first suspicion of infiltration, the drug infusion should be stopped. If infiltration is not certain, the line can be tested by attempting to aspirate blood, and careful infusion of a few milliliters of saline or dextrose solution. The infiltrated catheter should not be removed immediately.
It should be left in place to facilitate aspiration of fluid from the extravasation site, and, if appropriate, administration of an antidote directly into the extravasation site. To the extent possible, the extravasated drug solution should be removed from the subcutaneous tissues. Do NOT flush the line.
Flooding the infiltration site with saline or dextrose in an attempt to dilute the drug solution generally is not recommended.
Rather than minimizing damage, such a procedure may have the opposite effect by distributing the vesicant solution over a wider area. If an antidote is not going to be injected into the extravasation site, the infiltrated catheter should be removed. If an antidote is to be injected into the area, it should be injected through the catheter to ensure delivery of the antidote to the infiltration site. When this has been accomplished, the catheter should then be removed.
Two issues for which there is less consensus are the application of heat or cold, and the use of various antidotes. A variety of recommendations exist for each of these concerns; however, there is no consensus concerning the proper approach. Intermittent cooling of the area of infiltration results in vasoconstriction, which tends to restrict the spread of the drug.
It may also inhibit the local effects of some drugs eg, anthracyclines. Application of cold is usually recommended as immediate treatment for most drug extravasations, except the vinca alkaloids. The largest single published series of antineoplastic drug extravasations was patients reported by Larson in This series includes some of the more commonly used vesicants, including the anthracyclines, mechlorethamine, mitomycin, and the vinca alkaloids.
For patients, local application of cold 15 minutes four times a day for 3 days and close observation was the sole treatment. The remaining 56 patients received a variety of antidotes. Helpful as it may be, Larson's report does have some limitations. Agents such as the epipodophyllotoxins and taxanes which are occasionally associated with soft tissue damage were not included, nor were extravasations of nonantineoplastic agents mentioned.
The report included infiltrations of the vinca alkaloids, even though the literature recommends use of heat to treat these.
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