Definition and Basics

• DBP > 120 w/ potential end-organ damage
• Change in BP over change in time is the key not absolute BP
• HTN + neuro sx means NO overzealous normalization
• Decrease BP 20-25% from presenting BP

Ask ABCD

• Age
• Allergies
• BPs (previous)
• Current medications and what they take at home
• Diagnostics (i.e. labs)

Medications  

• hydralazine 10-20 mg PO/IV/IM q6°
  • Onset 10-20^#
  • Lasts 3-8°
  • Peripheral vasodilator, CO, HR

• labetalol 20 mg IV q6°
  • Onset 5-10^#
  • Lasts 3-6°
  • Beta-blocker can decrease HR

• enalaprilat 1.25-5 mg IV q6°
  • Onset 15-30^#
  • Lasts 6°
  • ACEI, NOT in AKI

• nicardipine 30 mg PO q8°
  • Calcium channel blocker

• nitroglycerin 0.4 mg SL q5^# ´3
  • 5-200 mcg/min IV
  • 5-10-15-20-30-40-60-80-100-120-140-160-180-200 mcg/min q3-5^#
  • Onset 3-5^#

• clonidine 0.1-0.2 mg PO q12°
  • MAX 0.8 mg in 24°
  • alpha2-agonist, rebound HTN