(精编)【高血压英文教学精品课件】 HYPERTENSION Emergencies Urgencies.pptVIP

HYPERTENSIONEmergencies Urgencies Stephen S. Levin, D.O. Definitions Emergencies Symptomatic Acute End-Organ Damage Diastolic B.P. usually 130 mmHg Urgencies Asymptomatic NO Acute End-Organ Damage Diastolic B.P. usually 110 mmHg; Systolic B.P. usually 180 mmHg Begin Treatment! This is a Hypertensive Emergency Begin to look for other causes of symptoms Parenteral Drugs for Treatment of Hypertensive Emergencies Diazoxide (Hyperstat IV) 1-3 mg/kg (up to 150 mg) IV bolus, q5-15 min; repeat q4-24 hr as needed 2-4 min 3-12 hr Nausea, hypotension, flushing, tachycardia, hypergly- cemia, aggravation of angina, fluid retention C: Syndromes of coronary insufficiency, (unless used with beta-blocking agent), cerebrovascular accident, hypersensi- tivity to sulfonamides Parenteral Drugs for Treatment of Hypertensive Emergencies Fenoldopam mesylate (Corlopam) 0.1-1.7 micrograms/kg/min IV infusion 5-15 min 1-4 hr Headache, dizziness, flushing, increased intraocular pressure, hypokalemia, dose-related tachycardia I: Severe hyperten-sion with renal insuffi-ciencyC: Glaucoma Hydralazine HCl (Apresoline) 10-20 mg IV or IM bolus, repeat q4-6 hr as needed (maximum dose, 40 mg) 10-20 min 3-8 hr Tachycardia, flushing, headache, vomiting, aggravation of angina I: CHFC: Coronary insufficiency, aortic dissection, cerebrovas-cular accident (may increase intracranial pressure) Parenteral Drugs for Treatment of Hypertensive Emergencies Enalaprilat (Vasotec I.V.) 1.25-5 mg q6 hr IV 15 min 6 hr Precipitous drop in blood pressure in high-renin states, variable response I: CHF C: Use with caution in patients with severe renal insufficiency (not receiving dialysis) Nicardipine HCl (Cardene) 5-15 mg/hr IV infusion 5-20 min 1-2 hr Tachycardia, headache, flushing, local phlebitis C: Greater than first-degree heart block, CHF Parenteral Drugs for Treatment of Hypertensive Emergencies Adrenergic Inhibitors Phentol-amine (Regitine) ?-blocker 5-20 mg IV, re