POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME (PRES)

Question 1

Clinical Features

Answer 1

Elevated blood pressures

Altered level of consciousness

Visual disturbances

Seizures

Question 2

Investigations

Answer 2

MRI

Check Magnesium Levels

Question 3

Management

Answer 3

Decrease MAP by 25%
Antiepileptics typically required
May require ICU management

Question 4

Blood Pressure Agents

Answer 4

Labetolol
Dosing: 20 mg IV with additional doses 20, 40, 80 to total 300 q 10 min
OR
1-2 mg / min

C/I:
Pheochromocytoma, CHF, Asthma, Heart Block

Hydralazine:
Dosing: 5 mg IV, repeat 5-10 mg q 20 min
Goal DBP<110