7-12. THE TREATMENT OF A HYPERTENSIVE CRISIS OR EMERGENCY
Patients presenting with extreme elevations of blood pressure and symptoms of
impending stroke, pulmonary edema, kidney failure, or heart attack must be promptly.
The following agents are used to treat hypertensive crisis:
a. Diazoxide (Hyperstat I.V.) This agent is administered by rapid intravenous
(I.V.) injection (150 to 300 milligrams immediately, repeated in 30 minutes and every
four hours if needed). When administered, this agent produces a fall in blood pressure
in from one to five minutes. Hyperglycemia and sodium retention are side effects
associated with this agent.
b. Nitroprusside (Nipride). Nitroprusside is administered by continuous
intravenous infusion at a rate of 0.5 to 0.8. micrograms per kilogram of patient weight
per minute. The patient must be closely observed, when he is receiving this drug since
overdosage of nitroprusside results in cyanide poisoning. Nitroprusside is not intended
for direct injection. Instead, the drug must be used as an infusion with sterile 5 percent
dextrose in water. The intravenous infusion must be used within four hours once it is
prepared. Furthermore, the prepared intravenous infusion must be protected from light
(for example: the bottle must be wrapped with foil). Nausea, vomiting, and headache
are side effects commonly associated with this agent.