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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Tuesday, June 28, 2011

Nicardipine vs labetalol

A randomized Comparative effectiveness trial of IV nicardipine versus Labetalol Use in the Emergency department    
Peacock WF et al. Critical Care, 06/28/2011                           

Patients treated with nicardipine are more likely to reach the physician–specified SBP target range within 30 minutes than those treated with labetalol.

"Conversely, although not evaluated in this analysis, several conditions exist for which calcium channel blockers are not recommended as first line agents. This is not necessarily because of a direct contraindication, but rather that other agents have clinical or theoretical advantages. This includes myocardial infarction, where oral beta-blockers confer a mortality reduction benefit, and in the setting of aortic dissection where the negative inotropic effect of beta-blockers is desirable to decrease shear forces in the false lumen of the dissection. In fact, labetalol has been specifically recommended for use in patients with aortic dissection because it has both alpha and beta blockade effects"