Initial approach to hypertension in the hemodynamics unit: review article

Schimit, Gustavo Teixeira Fulton; Silvestre, José Manoel da Silva; Sardinha, Wander Eduardo; Ramires, Eduardo Durante; Morais Filho, Domingos de; Tenório, Guilon Otávio Santos; Trevisan, Fernando Barbosa

doi:10.1590/S1677-54492013000200008

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Review Article • J. Vasc. Bras. 12 (2) • June 2013 • https://doi.org/10.1590/S1677-54492013000200008 linkcopy

Initial approach to hypertension in the hemodynamics unit: review article

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Abstract

Correct identification and early management of hypertensive disorders should be a part of the therapeutic repertoire of every professional working in hemodynamics units. Based on recent publications, this study aims to propose a practical approach to the identification and early management of these disorders in this type of service.

hypertension; blood pressure; therapeutics; antihypertensive agents

Medication	Mechanism	Initial dose	Effect begins	Maximum dose	Lasts	Contraindications	Adverse effects
Nitroprusside	Arterial and ve-nous vasodilator	0.3 μg/kg/min	Less than 1 minute	5 to 10 μg/kg/min	3 to 5 minutes	Relative: Kidney and liver failure	Toxicity by cyanide
Nitroglycerin	Primarily venous vasodilator	5 to 10 μg/kg/min	2 to 5 minutes	100-200 μg/kg/min	3 to 10 minutes	-	Headache
Metoprolol	Beta-blocker	5 mg in 5 minutes	5 to 10 minutes	15-20 mg	hours	2nd and 3rd degree AVB, severe HF, asthma	Bradycardia, TAVB, bron-chospasm
Propranolol	Beta-blocker	1 mg in 5 minutes	5 to 10 minutes	6-8 mg	hours	2nd and 3rd degree AVB, severe HF, asthma	Bradycardia, TAVB, bron-chospasm
Labetalol	Alpha- and beta-blocker	10-20 mg in 10 minutes	5 min-utes	300 mg	4 to 8 h	2nd and 3rd degree AVB, severe HF, asthma	Bradycardia, TAVB, bron-chospasm

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