Flashcards in Hypertensive Emergencies Deck (50)
Hypertensive crisis is defined as SBP > _______ or DBP >________
180mmHg; 120 mm HG
Pts with acute elevation in BP levels and do not demonstrate acute end-organ damage are diagnosed with __________
Pts with acute elevation in BP levels and DO demonstrate life threatening acute end-organ failure are diagnosed with _______________ and will require ______ ________
Hypertensive crisis or emergency ; IV medications
Acute end organ damage can manifest as ______,_______, ________, ______, ______,_____, ____________, _______
Encephalopathy; ischemic and hemorrhagic strokes; Acute aortic dissection; ACS; HF; Pulmonary edema or resp failure; ARF; HELLP (hemolysis, elevated liver enzymes, low platelets) preeclampsia or eclampsia
Pt with labile BP should be monitored in _____ and ________ ____ ______ monitoring
ICU; intra-arterial BP
Oral therapy should be used in patients with _________ ______with a goal of obtaining a gradual lowering of BP levels by ____% over ___ to ___ hours
Hypertensive urgency; 20; 24; 48
If IV therapy is given to patient with ________with no evidence of end organ damage, the rapid reduction in BP may lead to ________ and _____ to organs that had become dependent on the increased blood flow.
hypertensive urgency; ischemia and infarction
IV forms of medication used in hypertensive emergencies should have _____onset and _____duration
IM and SL in hypertensive emergencies should be avoided because they lack the ability to be ______ and may lead to _______ ______ ______ levels
titrated; unpredictable drop in BP
Goal of BP reduction in hypertensive emergency should be _____ to _____ % in ____In the first ____ to _____ minutes; And in ______ ________ ______, the reduction should occur in less than ___ to ___ minutes , targeting a SBP of less than ______ and MAP less than ________
10-15; DBP; 30-60; ascending aortic dissection; 5-10; 120 <80
Rapid reduction in BP slow __________
progression of end organ damage.
Drugs meeting ideal characteristics for the management of Hypertensive crisis or emergency are _____ ____ ____ _____
labetalol, esmolol, nicardipine and fenoldopam
Esmolol is a _________ (cardioselective or non-cardioselective, ____adrenergic blocker without peripheral _____blocking activity and therefore no ______effects
cardioselective; Beta; Alpha; vasodilatory
For acute aortic dissection the recommended agent to decrease BP is _______. A combination of ______ and a ________ is recommended.
labetalol.; beta blocker; vasodilator.
For acute ischemic stroke or intracerebral bleed, the recommended agent to decrease BP is _________
For Acute MI, the recommended agent to decrease BP is _________
Labetalol plus nitroglycerin
Acute pulm edema/ DIASTOLIC Dysfunction, the recommended agents to decrease BP is ______ plus _______ + _______
Esmolol Plus nitroglycerin + Loop diuretic
Acute pulm edema/ SYSTOLIC Dysfunction agents to decrease BP is ______ plus _______ + _______
Nicardipine Plus nitroglycerin + Loop diuretic
Contraindicated in pregnancy are ______ and ______
Nitroprusside and ACEI
Enalaprilat electrolyte imbalance _________(possible)
For ______monitor serum potassium every 6 h during infusion
Adverse effects of Esmolol
Is hydralazine safe in pregnancy? Adverse effect:_________other medications with that adverse effect are __________ and ______
Yes ; Reflex tachycardia; nicardipine; nitroglycerin
Is labetalol safe in pregnancy? Adverse effect
How is esmolol administered? What is recommended for monitoring?
bolus followed by infusion; Intra-arterial BP monitoring.
The preferred medications for aortic aneurysm or dissection is _________
Labetalol is a combined ______and (selective or nonselective) ______adrenergic receptor blocker than reduces ______ while maintaining ______ and does not reduce ____, _____, or ____blood flow
Alpha; Beta; afterload, cardiac output; cerebral, coronary and renal
What is the preferred therapy in the treatment of renal hypertensive patients is _______ and that is because _____ ____ levels are reduced by the administration of__________
Labetalol; elevated renin; labetalol.
The use of _______ in the treatment of hypertensive emergencies and urgencies both are safe in pregnancy