Hypertensive Emergencies Flashcards
(33 cards)
What is a hypertensive crisis
DBP > 120 leading to vascular injury and organ damage
What is a hypertensive emergency
Severe HTN with damage to brain, CVS, kidneys
What is hypertensive urgency
Very high HTN w/o damage to organs
Causes of Hypertensive emergency
Essential HTN Renal parenchymal or renovascular disease Eclampsia Pheochromocytoma Drugs
How much should BP be reduced in first hour
25%
What can happen with abrupt BP reduction
MI
Stroke
Visual changes
DOC Hypertensive emergency
Sodium Nitroprusside
What are the drugs used in hypertensive crisis
Sodium Nitroprusside Labetalol Fenoldopam Nicardipine Nitroglycerine Diazoxide Phentolamine Esmolol Hydralazine
DOC pt with cardiac ischemia, angina or post cardiac bypass
Nitroglycerine
DOC pt with pheochromocytoma episode
Phentolamine
DOC pt with eclampsia
Hydralazine
Used for aortic dissection or post-op HTN
Esmolol
Does not cause reflex tachycardia
Labetalol
Safe in pts with renal insufficiency
Fenoldopam
Ca channel blocker
Nicardipine
What do you give with Sodium Nitroprusside
Beta blocker (for reflex tachycardia)
Why is Fenoldopam safe in renal insufficiency
Maintains renal perfusion as it lowers BP
Shortest to Longest half life
Sodium Nitroprusside Nitroglycerin Fenoldopam Nicardipine Labetalol Diazoxide
Contraindications for Labetalol
COPD, Asthma
2nd or 3rd AV block
Bradycardia
Contraindication for Fenoldopam
Glaucoma
Can cause reflex tachycardia
Sodium Nitroprusside
Nicardipine
Diazoxide
Can cause Hypotension
Sodium Nitroprusside
Diazoxide
Can cause Cynide Toxicity
Sodium Nitroprusside
Treat CN toxicity in Sodium Nitroprusside
Sodium Thiosulfate
