Treatment Of Hypertension

Question 1

What is HNT emergency and HNT urgency

Answer 1

Medical emergency
Very high bp ( systolic> 180 diastolic> 120)mmHg
Progressive end organ damage -
(Retinopathy
Renal dysfunction
MI
Hypertensive encephalopathy )

HNT urgency = if no end organ failure

Question 2

Tx of HNT emergency

Answer 2

Bp reduce by ≤25% over 1hr
↓
Then to 160/100 over next 2-6 hr
↓
Normal over next 48 hrs

Drugs=›
Nicardipine - start i.v. c 5mg/h → max. 15mg/h
Fast acting short duration , reflex tachycardia can occur

Labetalol initial bolus-20mg/h i.v.
↓
20-30mg/h i.v. bolus every 10min. (Max. 300)
Avoid in pt. c COPD /bronchial asthma/ heart failure

Nitroglycerin start 5mcg/h max. 100mcg/h

Sodium nitroprusside start i.v. 0.25-0.5 MCG/kg/min max. 10mcg/kg/min
Monitor for cyanide toxicity