5. Hypertensive Crisis/Emergency

Question 1

Hypertensive Crisis/Emergency

Answer 1

One question may focus on this topic. The question will usually be related to how the topic differs from hypertensive urgency or what drugs are used for trmt

Question 2

Hypertensive emergency or CRISIS is…

Answer 2

elevated BP with evidence of end organ damage (brain, heart, kidney, retina) that can be related to acute hypertension–>needs critical care admission.

Question 3

Hypertensive urgency is…

Answer 3

elevated BP without evidence of acute end organ damage –>usually no need for critical care admission.

Question 4

Treatment of hypertensive crisis or emergency

Answer 4

emergent lowering of BP needed:
1. Nitroprusside (Nipride)
2. Labetalol

Question 5

Nitroprusside (Nipride)

Answer 5

-Preload AND afterload reducer
-Assess for cyanide toxicity secondary to drug metabolite (Thiocyanate): mental status change (restlessness, lethargy), tachycardia, seizure, a need for increase in dose, unexplained metabolic acidosis, esp in those with renal impairment or when a drug is used > 24 hrs

Question 6

Labetalol (Normodyne, Trandate)

Answer 6

-Intermittent IV doses preferred to a continuous infusion, due to the possibility of continuing the drug beyond the maximum dose of 300 mg.
-Duration of effect persists 4 -6 hrs after IV dose is discontinued.

Question 7

Greatest risk of hypertensive crisis/emergency is

Answer 7

STROKE