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Flashcards in Hypertensive Emergencies Deck (50)
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1

Hypertensive crisis is defined as SBP > _______ or DBP >________

180mmHg; 120 mm HG

2

Pts with acute elevation in BP levels and do not demonstrate acute end-organ damage are diagnosed with __________

Hypertensive urgency

3

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

4

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

5

Pt with labile BP should be monitored in _____ and ________ ____ ______ monitoring

ICU; intra-arterial BP

6

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

7

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

8

IV forms of medication used in hypertensive emergencies should have _____onset and _____duration

fast; short

9

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

10

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

11

Rapid reduction in BP slow __________

progression of end organ damage.

12

Drugs meeting ideal characteristics for the management of Hypertensive crisis or emergency are _____ ____ ____ _____

labetalol, esmolol, nicardipine and fenoldopam

13

Esmolol is a _________ (cardioselective or non-cardioselective, ____adrenergic blocker without peripheral _____blocking activity and therefore no ______effects

cardioselective; Beta; Alpha; vasodilatory

14

For acute aortic dissection the recommended agent to decrease BP is _______. A combination of ______ and a ________ is recommended.

labetalol.; beta blocker; vasodilator.

15

For acute ischemic stroke or intracerebral bleed, the recommended agent to decrease BP is _________

Nicardipine

16

For Acute MI, the recommended agent to decrease BP is _________

Labetalol plus nitroglycerin

17

Acute pulm edema/ DIASTOLIC Dysfunction, the recommended agents to decrease BP is ______ plus _______ + _______

Esmolol Plus nitroglycerin + Loop diuretic

18

Acute pulm edema/ SYSTOLIC Dysfunction agents to decrease BP is ______ plus _______ + _______

Nicardipine Plus nitroglycerin + Loop diuretic

19

Contraindicated in pregnancy are ______ and ______

Nitroprusside and ACEI

20

Enalaprilat electrolyte imbalance _________(possible)

hyperkalemia

21

For ______monitor serum potassium every 6 h during infusion

Fenoldopam

22

Adverse effects of Esmolol

Thromophlebitis extravasation

23

Is hydralazine safe in pregnancy? Adverse effect:_________other medications with that adverse effect are __________ and ______

Yes ; Reflex tachycardia; nicardipine; nitroglycerin

24

Is labetalol safe in pregnancy? Adverse effect

yes; Bronchospasm

25

How is esmolol administered? What is recommended for monitoring?

bolus followed by infusion; Intra-arterial BP monitoring.

26

The preferred medications for aortic aneurysm or dissection is _________

Esmolol.

27

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

28

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.

29

The use of _______ in the treatment of hypertensive emergencies and urgencies both are safe in pregnancy

Labetalol

30

Patients that may have an increase responsiveness of labetalol are patients with _______Impairment

Hepatic