Hypertensive crisis

Hypertensive Crisis:
  • sudden, dangerous, elevation in BP
  • can lead to organ and tissue damage quickly
  • BP is > 180/120
  • Symptoms: headache, confusion, vision changes, chest pain, dyspnea, sensory deficit, seizure activity 
  • Goal: reduce BP by no more than 25% w/in an hour, then toward 160/100 w/in 2-6hours. 
  • It is important to avoid rapid or excessive BP decreases that may lead to renal, cerebral or cardiac ischemia.
  • IV medication for rapid and predictable action
  • Nipride - vasodilator, easy to titrate
  • Vasodilator - nitroglycerin, apresoline
  • Enalaprilat - ace inhibitor

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