How to Treat Hypertensive Crisis?

Medical Treatment::

• 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

Intravenous therapy

• Labetalol, IV, 2 mg/minute to a total dose of 1-2 mg / kg.
• Caution in acute pulmonary oedema.

OR
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.

Oral therapy
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.