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Flashcards in Hypertensive emergencies Deck (24):
1

Sodium nitroprusside effects

DOC for hypertension emergency
Prompt vasodilation and venodilation
Reflex tachycardia (also given beta blocker)

2

Sodium nitroprusside PK

IV only ->can be poisonous
1-2 min half life so need continuous infusion

3

Sodium nitroprusside adverse

Hypotension *overdose*
Abdominal cramping, nausea, vomiting

***Cyanide toxicity**** (metabolite) can be treated with SODIUM THIOSULFATE

4

Labetalol description

combined alpha and beta blocker

5

Fenoldopam

Arteriolar dilation
**Maintains renal perfusion as it lowers BP (protects the kidney)***

Promotes natriuresis

6

Labetalol effects

No reflex tachycardia
First line agent coronary artery disease, HF, and post MI

7

Labetalol contraindication

Asthma, COPD
2nd or 3rd degree AV block
Bradycardia

8

Fenoldopam description

Peripheral D1 agonist
Safe in patients with renal insufficiency

9

Fenoldopam contraindication

Glaucoma

10

Nicardipine description

Calcium channel blocker
Dihydropyridine

11

Nicardipine effects

Vascular smooth muscle relaxation

12

Nicardipine Adverse

Reflex tachycardia

13

Nitroglyceran description

DOC for patients with cardiac ischemia, angina, or s/p cardiac bypass

14

Nitroglyceran effects

arterial and venous vasodilation

15

Diazoxide effects

Arteriolar dilation-prevents vascular smooth muscle contraction by opening potassium channels and stabilizing the membrane potential

Can also be used to treat hypoglycemia secondary to an **insulinoma** by inhibiting insulin release

16

Diazoxide adverse

Hypotension
Reflex tachycardia
Sodium and Water retention

17

Phentolamine description

DOC for patients with catecholamine release emergencies (pheochromocytoma)

18

Esmolol description

used for aortic dissection or post op hypertension
Beta 1 agonist

19

Hydralazine description

DOC for pregnancy induced hypertensive emergencies related to eclampsia

20

Hypertensive crisis

Severe, acute elevation in BP DBP >120 mmHg that can lead to vascular injury and organ damage

21

Hypertensive Emergency

Severe HTN with signs of damage to target organs (brain, CVS, kidneys); immediate BP reduction is required with IV drugs

22

Hypertensive Urgency

Very high BP without target organ damage; immediate reduction is not required (start on oral combination and follow up on outpatient basis)

23

Treatment

BP should be progressively reduced (25% in the first hour) using short acting titratable IV drug -> abrupt decreases can lead to MI, stroke, or visual changes

24

Causes of hypertension emergency

Essential HTN, renal parenchymal or renovascular disease, eclampsia, endocrine (pheochromocytoma, etc) or drugs (ex cocaine)