Title: Hypertensive Emergencies<br/>Author: Michael Winters<br/><a href='http://umem.org/profiles/faculty/141/'>[Click to email author]</a><hr/><p>
        <strong><u>Hypertensive Emergency Pearls</u></strong></p>
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                It is well known that a hypertensive emergency is not defined by an arbitrary blood pressure reading.  Rather, it is characterized by the presence of end-organ dysfunction, often due to a sudden increase in sympathetic activation.</li>
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                When treating patients with a hypertensive emergency, consider the following:
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                                Many are hypovolemic due to a pressue-induced natriuresis - give them fluids and avoid diuretics.</li>
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                                BP should be reduced in a controlled manner using short-acting titratable intravenous agents. Rapid reductions in BP can lead to organ hypoperfusion.</li>
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                                Avoid oral, sublingual, and transdermal medications until end-organ dysfunction has resolved.</li>
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                                Clevidipine is the newest agent
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                                                A third-generation dihydropyridine</li>
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                                                Relaxes arteriolar smooth muscle</li>
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                                                Rapid onset (2-4 min) and short acting (5-15 min)</li>
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                                                Compares favorably with nicardipine in available studies</li>
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<fieldset><legend>References</legend>

                <p>
        Monnet X, Marik PE. What's new with hypertensive crisis? <em>Intensive Care Med</em> 2015; 41:127-130.</p>
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