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33 Cards in this Set
- Front
- Back
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What is the definition of severe HTN?
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diastolic of 115 or higher
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What is the definition of hypertensive emergency?
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acute elevation of BP causes rapid and progressive end organ damage
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What % of patients with HTN have end organ damage?
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<1%
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What % of medical urgency/emergency is due to hypertensive crisis?
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25%
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What are some signs of urgency? Emergency?
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1. H/A, epistaxis, faintness
2. chest pain, dyspnea, neuro deficit |
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What are some end organ damages?
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1. cerebral infarct
2. acute pulmonary edema 3. hypertensive encephalopathy 4. cerebral hemorrhage |
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What is the goal of hypertensive emergency treatment?
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1. lower mean arterial pressure by 20-25% or reduce diastolic pressure to 100-110 over 24-48 hours
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What happens if blood pressure is dropped too quickly?
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ischemia
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What should urine output be maintained at in hypertensive emergency?
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>20m/hr
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What drugs are used to treat hypertensive encephalopathy?
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1. nitroprusside-instantaneous
2. labetalol-give IV bolus, then TKO 3. fenoldopam-vomiting 4. nitroglycerin-MI's |
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What 3 drugs are given during an MI?
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1. nitroglycerine infusion
2. morphine 3. beta blocker |
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What effect does nitroglycerine have on MI?
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decreases preload, afterload, and dilates coronary arteries
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How can morphine affect an MI patient?
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decreses pain, which drops BP, which decreases preload and vasodilates patient
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What drugs are used to treat CHF?
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1. nitroglycerine
2. morphine 3. nitroprusside 4. fenoldopam |
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What drugs are used to treat renal failure?
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1. nitroprusside
2. labetalol 3. fenoldopam |
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What drugs are used to treat an aortic dissection?
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nitroprusside and beta blocker
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What drug is used in black males to treat CHR and HTN?
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hydralazine
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What are some sx of hypertensive emergencies?
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1. HTN
2. H/A 3. N & V 4. seizures 5. retinopathy 6. visual disturbances 7. thrombosis 8. acute renal failure 9. chest pain 10. dyspnea/orthopnea 11. focal neuro deficits 12. stupor coma 13. pulmonary edema 14. hemorrhage 15. embolus 16. abnormal pain |
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What meds can cause hyptertensive emergencies?
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1. decongestants
2. steroids 3. drugs of abuse 4. amphetamines 5. appetite suppression 6. MAO inhibitors 7. cocaine |
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What are some events that can cause hypertensive emergency?
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1. withdrawal of antihypertensive
2. withdrawal of CNS depressant 3. eclampsia 4. TTP 5. pheochromocytoma 6. idiopathic hyptertensive 7. renal disease 8. severe burns 9. post operative hypertensive 10. aneurysm |
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What would be a clue to a coarctation?
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normal BP in one arm, very high in the other
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What might show up on a CBC that would be a clue to hypertensive crisis?
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1. hemolytic anemia
2. thrombocytopenia 3. microantiopathies |
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What might the serum electrolytes show in a hypertensive emergency?
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hypokalemic acidosis
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What is the formula for mean arterial pressure?
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diastolic + (systolic-diastolic)
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Can nitroprusside be given during pregnancy?
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no
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How long does labetalol take to have effect?
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10-15 minutes
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Should diaoxizide be used in hypertensive emergency?
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no, bottoms out BP too quickly
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What kind of drug is trimethaphan? Who uses it?
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1. ganglionic blocker
2. neurosurgeons |
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What kind of drug is magnesium sulfate? Who is this usually used for?
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1. vasodilator
2. pregnant women |
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What can happen in magnesium sulfate overdose?
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paralysis
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What other drugs can phentolamine be used with?
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only with lanoxin and insulin
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What vasodilator is recommended in pregnancy?
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hydralazine
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Furosemide is used with what other drug to treat hypertensive pulmonary edema?
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nitroglycerine
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