Acutely elevated blood pressure, particularly
diastolic pressure > 120–130 mmHg without evidence of target organ
damage. Goals: Lower mean arterial pressure to goal or near goal within
several hours. Oral medications can be used.
Hypertensive emergency: Hypertension with evidence of target organ
damage ( brain, heart, kidneys, eyes). Goals: The goal of initial
therapy is to terminate ongoing target organ damage. Lower mean arterial
pressure by 20- 25% or diastolic pressure to <100 to 110 mmHg within
(JNC VI) states that the initial goal of therapy in hypertensive
emergencies is to reduce mean arterial pressure (MAP) by 20 to 25%
(within minutes to 2 hours), then toward 160/100 mmHg within 2 to 6
hours, avoiding excessive falls in pressure that may precipitate renal,
cerebral, or coronary ischemia.9 If symptoms worsen (e.g., an increase
in chest pressure, a decline in mental status) during the reduction of
systemic blood pressure, the rate of the reduction should be slowed or
treatment should be temporarily halted.
Dose: 12.5 to 25 mg orally repeat as needed or give SL. Onset/ duration: 15-30 min/6-8 hr, SL 10-20 min/2-6 hr.
Dose: Clonidine 0.1-0.2 mg orally x 1, followed by 0.05 to 0.1
mg every 1 to 2 hours to a maximum dose of 0.6 to 0.7 mg. Onset/ duration: 30-60 min/8-16 hr.
Many patients may require at least 2 agents. Additional agents to
(1) lasix 20mg (rpt as necessary)
(2) nifedipine SR 30mg x1
(3) felodipine 5 mg x 1.
Listed dosages are for - Adult patients ONLY. PLEASE READ THE
DISCLAIMER CAREFULLY BEFORE
ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE
TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.
GlobalRPH does not directly or indirectly practice medicine or provide
medical services and therefore assumes no liability whatsoever of any
kind for the information and data accessed through the Service or for
any diagnosis or treatment made in reliance thereon.