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Updated: Jun 21, 2026
06:59
A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Intravenous therapy for hypertensive emergencies, part 2
Denise Rhoney1, W Frank Peacock
1Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Avenue, Detroit, MI 48201, USA. drhoney@wayne.edu
Summary
Rapidly reducing blood pressure with intravenous antihypertensive agents is crucial for managing hypertensive emergencies and preventing end-organ damage. Optimal treatment involves selecting the right agent based on patient factors and drug pharmacology.
Area of Science:
- Cardiology
- Pharmacology
- Emergency Medicine
Background:
- Hypertensive emergencies affect an estimated 500,000 individuals annually in the U.S.
- These emergencies can lead to significant end-organ damage and morbidity.
- Prompt and controlled reduction of blood pressure is vital to mitigate these risks.
Purpose of the Study:
- To review intravenous antihypertensive agents for treating hypertensive emergencies.
- To highlight the characteristics and selection criteria for these agents.
Main Methods:
- Review of current literature and clinical guidelines.
- Analysis of pharmacological properties of intravenous antihypertensive agents.
- Consideration of patient-specific factors in treatment selection.
Main Results:
- Several intravenous agents are recommended for hypertensive emergencies, including nicardipine, nitroprusside, fenoldopam, nitroglycerin, enalaprilat, hydralazine, labetalol, esmolol, phentolamine, and clevidipine.
- These agents generally offer rapid onset and offset of action with predictable responses.
- Effective management requires tailoring drug choice to patient comorbidities and end-organ damage.
Conclusions:
- Timely recognition and treatment initiation are paramount in minimizing end-organ damage.
- Individualized drug selection optimizes patient outcomes in hypertensive emergencies.
- Careful consideration of pharmacology and patient factors ensures effective blood pressure management.
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