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A hypertensive emergency is a clinical condition in which blood pressure is significantly elevated and must be reduced rapidly to prevent end-organ damage. It requires immediate pharmacological intervention.
The following medications are commonly used to manage hypertensive emergencies:
Each of these drugs has distinct mechanisms of action and side effects. Understanding their properties and risks is essential for appropriate management.
Medication | Mechanism of Action | Effects | Side Effects/Risks |
---|---|---|---|
Nitroprusside | Short-acting vasodilator (dilates arteries and veins); increases cGMP via NO release | Reduces blood pressure rapidly | Cyanide toxicity (due to cyanide release) |
Fenoldopam | Dopamine D1 receptor agonist; vasodilation in coronary, peripheral, renal, and splanchnic vessels | Lowers blood pressure, increases natriuresis | Hypotension, tachycardia |
Labetalol | Non-selective beta-blocker and alpha-1 antagonist; decreases heart rate and vasodilation | Reduces heart rate and blood pressure | Bradycardia, hypotension, fatigue |
Clevidipine | Calcium channel blocker (dihydropyridine); smooth muscle relaxation in arterial vessels | Lowers blood pressure by reducing systemic vascular resistance | Reflex tachycardia, hypotension |
Nicardipine | Calcium channel blocker (dihydropyridine); vasodilation, primarily in arteries | Reduces blood pressure without significant effect on heart rate | Tachycardia, hypotension |