Definition and Basics
DBP > 120 w/ potential end-organ damage
Change in BP over change in time is the key not absolute BP
HTN + neuro sx means NO overzealous normalization
Decrease BP 20-25% from presenting BP
Ask ABCD
Age
Allergies
BPs (previous)
Current medications and what they take at home
Diagnostics (i.e. labs)
Medications
hydralazine 10-20 mg PO/IV/IM q6°
Onset 10-20#
Lasts 3-8°
Peripheral vasodilator, CO, HR
labetalol 20 mg IV q6°
Onset 5-10#
Lasts 3-6°
Beta-blocker can decrease HR
enalaprilat 1.25-5 mg IV q6°
Onset 15-30#
Lasts 6°
ACEI, NOT in AKI
nicardipine 30 mg PO q8°
Calcium channel blocker
nitroglycerin 0.4 mg SL q5# ´3
5-200 mcg/min IV
5-10-15-20-30-40-60-80-100-120-140-160-180-200 mcg/min q3-5#
Onset 3-5#
clonidine 0.1-0.2 mg PO q12°
MAX 0.8 mg in 24°
alpha2-agonist, rebound HTN