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How to Treat Hypertensive Crisis?
- Admit the patient to a high-care setting for intravenous drug therapy and close monitoring. Do not lower the BP by >25% within 30 minutes to 2 hours
- In the next 2-6 hours, aim to decrease BP to 160/100 mmHg
- This may be achieved by the use of intravenous or oral drugs
- Labetalol, IV, 2 mg/minute to a total dose of 1-2 mg / kg.
- Caution in acute pulmonary oedema.
If myocardial ischaemia and CCF:
- Glyceryl trinitrate, IV, 5-10 mcg / minute.
- Furosemide, IV, 40-80 mg.
- Duration of action: 6 hours.
- Potentiates all of the above drugs.
ACE inhibitor, e.g:
- Enalapril, oral, 2.5 mg as a test dose
- Increase according to response, to a maximum of 20 mg daily.
- Monitor renal function.