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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.