Hypertensive Criss Flashcards
blood pressure crisis
180/120
biggest cause of hypertensive crisis
medication non adherence
goals of hypertensive emergency by hour
hour 1: reduce max 25%
hour 2-6: reduce < 160/100-110
hour 6-48: reduce BP to goal
why should BP be lowered gradually?
autoregulation of cerebral flow
DHP calcium channel blockers
nicardipine and clevidipine
nicardipine contraindication
aortic stenosis
clevidipine contraindications
aortic stenosis, soy/egg allergy
clevidipine side effects
atrial fib, elevates triglycerides
vasodilators
nitroglycerin, sodium nitroprusside, hydralazine
nitroglycerin and sodium nitroprusside side effects
tolerance with 24-48 hour use max, PDE5 interaction, headache and reflex tachycardia, cyanide tox (prusside)
hydralazine side effects
IV push, not titratable, used in pts with bradycardia
beta blockers drugs
labetalol, esmolol
labetalol contraindicatons
severe bradycardia, reactive airway disease
esmolol pearls
cardioselective (tolerated in reactive airway disease), adjunct only!
enalaprilat pearls
IV push! CI in AKI, hyperkalemia, MI, artery senosis
clonidine use
PO option maybe in clinic setting or no IV access, can cause hypertensive withdrawal
which med has egg/soy allergy
clevidipine
which is not titratable infusion?
hydralazine, enalaprilat, clonidine
acute decompensated HF with pulmonary edema
nitroglycerin/sodium nitroprusside
AVOID: beta blockers and non-DHP CCBs
aortic dissection
beta blocker then vasodilator (nicardipine,clevidipine,nitroprusside)
acute coronary syndrome
beta blocker, nitroglycerin, nicardipine, sodium nitroprusside
reduced ejection fraction avoid what drug?
beta blockers
AKI
dont use enalaprilat or sodium nitroprusside
eclampsia/severe preeclampsia
labetalol, hydralazine, nicardipine
stroke
nicardipine, clevidipine, labetabolol
