Hypertensive Criss

Question 1

blood pressure crisis

Answer 1

180/120

Question 2

biggest cause of hypertensive crisis

Answer 2

medication non adherence

Question 3

goals of hypertensive emergency by hour

Answer 3

hour 1: reduce max 25%
hour 2-6: reduce < 160/100-110
hour 6-48: reduce BP to goal

Question 4

why should BP be lowered gradually?

Answer 4

autoregulation of cerebral flow

Question 5

DHP calcium channel blockers

Answer 5

nicardipine and clevidipine

Question 6

nicardipine contraindication

Answer 6

aortic stenosis

Question 7

clevidipine contraindications

Answer 7

aortic stenosis, soy/egg allergy

Question 8

clevidipine side effects

Answer 8

atrial fib, elevates triglycerides

Question 9

vasodilators

Answer 9

nitroglycerin, sodium nitroprusside, hydralazine

Question 10

nitroglycerin and sodium nitroprusside side effects

Answer 10

tolerance with 24-48 hour use max, PDE5 interaction, headache and reflex tachycardia, cyanide tox (prusside)

Question 11

hydralazine side effects

Answer 11

IV push, not titratable, used in pts with bradycardia

Question 12

beta blockers drugs

Answer 12

labetalol, esmolol

Question 13

labetalol contraindicatons

Answer 13

severe bradycardia, reactive airway disease

Question 14

esmolol pearls

Answer 14

cardioselective (tolerated in reactive airway disease), adjunct only!

Question 15

enalaprilat pearls

Answer 15

IV push! CI in AKI, hyperkalemia, MI, artery senosis

Question 16

clonidine use

Answer 16

PO option maybe in clinic setting or no IV access, can cause hypertensive withdrawal

Question 17

which med has egg/soy allergy

Answer 17

clevidipine

Question 18

which is not titratable infusion?

Answer 18

hydralazine, enalaprilat, clonidine

Question 19

acute decompensated HF with pulmonary edema

Answer 19

nitroglycerin/sodium nitroprusside
AVOID: beta blockers and non-DHP CCBs

Question 20

aortic dissection

Answer 20

beta blocker then vasodilator (nicardipine,clevidipine,nitroprusside)

Question 21

acute coronary syndrome

Answer 21

beta blocker, nitroglycerin, nicardipine, sodium nitroprusside

Question 22

reduced ejection fraction avoid what drug?

Answer 22

beta blockers

Question 23

AKI

Answer 23

dont use enalaprilat or sodium nitroprusside

Question 24

eclampsia/severe preeclampsia

Answer 24

labetalol, hydralazine, nicardipine

Question 25

stroke

Answer 25

nicardipine, clevidipine, labetabolol