{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T14:43:43Z","timestamp":1793371423485,"version":"4.5.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hyperkalemia is a potentially life-threatening electrolyte abnormality often associated with renin\u2013angiotensin\u2013aldosterone system (RAAS) inhibitors, renal dysfunction, or potassium-sparing agents. Non-selective beta-blockers, including labetalol, may also precipitate hyperkalemia through beta-2 (\u03b2-2)-adrenergic blockade, although this adverse effect is underrecognized, particularly in patients without underlying renal disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 59-year-old man with hypertension, diabetes, asthma, and polysubstance use disorder presented with severe chest pain and hypertensive emergency (243\/132 mmHg). Imaging revealed aortic dilatation and confirmed acute type B aortic dissection. After initial medical management with intravenous (IV) esmolol and nicardipine, oral labetalol was initiated and escalated to 600 mg for anti-impulse therapy. The patient developed persistent, non-hemolyzed hyperkalemia (5.2 to 5.8 mmol\/L) temporally correlating with labetalol dose escalation, despite preserved renal function (serum creatinine 1.4 to 1.8 mg\/dL) and absence of RAAS inhibitors or heparin exposure. Conservative management failed, and the patient underwent thoracic endovascular aortic repair (TEVAR) with thoracic branch endoprosthesis (TBE). Post-operatively, labetalol was discontinued and replaced with carvedilol. Serum potassium (K+) normalized within 48 hours and remained without further K+ lowering agents. Naranjo Adverse Drug Reaction Probability Scale assessment yielded a score of 7, indicating a probable adverse drug reaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Labetalol may induce clinically significant hyperkalemia independent of renal impairment or typical precipitating medications. This case highlights the importance of monitoring K+ in patients receiving labetalol for acute aortic syndromes and supports carvedilol as a potentially safer non-selective beta-blocker alternative with respect to K+ homeostasis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajhp\/zxag297","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T11:49:04Z","timestamp":1791632944000},"source":"Crossref","is-referenced-by-count":1,"title":["Labetalol-induced hyperkalemia in acute aortic dissection: A rare but clinically relevant adverse effect"],"prefix":"10.1093","author":[{"given":"Faizan","family":"Butt","sequence":"first","affiliation":[{"name":"From the Department of Cardiology, Rutgers Jersey City Medical Center , Jersey City, NJ ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoha","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rutgers Newark Beth Israel Medical Center , Newark, NJ ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7596-8057","authenticated-orcid":false,"given":"Paul M","family":"Badua","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Rutgers Jersey City Medical Center , Jersey City, NJ ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,12]]},"container-title":["American Journal of Health-System Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajhp\/advance-article-pdf\/doi\/10.1093\/ajhp\/zxag297\/71874151\/zxag297.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajhp\/advance-article-pdf\/doi\/10.1093\/ajhp\/zxag297\/71874151\/zxag297.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T14:16:39Z","timestamp":1791814599000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajhp\/advance-article\/doi\/10.1093\/ajhp\/zxag297\/8910591"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,12]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/ajhp\/zxag297","relation":{},"ISSN":["1079-2082","1535-2900"],"issn-type":[{"value":"1079-2082","type":"print"},{"value":"1535-2900","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,12]]},"article-number":"zxag297"}}