H?Commonly used drugs for hypertensive emergenciesll
Low pressure magazine is a non-diuretic thiazide antihypertensive drug.The intravenous?This administration directly dilates the smooth muscles of small arteries.The antihypertensive effect is strong and rapid.When the blood pressure drops the heart rate and cardiac output increase.Does not affect kidney blood flow,Suitable for hypertensive crises, hypertensive encephalopathy, malignant hypertension, etc.
commonly used 50 ~ 100mg / time,Undiluted intravenous?se injection (within 10-15 seconds),3-4 minutes reach the H?highlight of the action,H?lt 12 hours or l?longer.If the blood pressure is not satisfied,Give 100 ~ 150 mg every 5 minutes.Until the blood pressure drops to the ideal level?llt or the total amount is 300 mg?gt,Due to the increasedreflex heart rate and increasedTherefore, it is not suitable for patients with angina and aortic dissection.May cause water and sodium retention,Therefore, diuretics should be added 2 to 3 days after the medication: Can hyperglyc?mie foreignsen.Therefore, diabetes is not used, since this becomes a pl?can lead to an additional work stop.Will w?not used during labor.
At the same time, small arteries and venules expand directly,Reduce the pre- and post-load on the heart.Suitable for various hypertensive emergenciesll,Especially those with heart failure.The effect is strong and quick,Short half-life,The blood pressure started within a few seconds after the intravenous?sweet drop to fall.The antihypertensive effects disappeared after stopping the drug for a few minutes.usually 25 to 20 micrograms per minute are used.Set the drip rate according to the blood pressure.W?during the instillation process, blood pressure, Heart rate, Closely monitors breathing and other vital indicators.Since the prepared liquid is easy to decompose and fails when exposed to light,So it should be equipped with new uses,And will you replace the fresh L?solution every 6 to 8 hours.The liquid bottle is protected from light,Bige infusion amounts k?Can cause cyanide poisoning.Manifested as Schw?che, nausea, Tinnitus, Hypothyroidism and Mental Disorderchanges,However, the above side effects are rare.
Camphormifene is a ganglion blocker.The antihypertensive effect is strong and rapid,Used in hypertensive encephalopathy, hypertensive acute left heart failure, Cerebral hemorrhage, acute aortic dissection, etc. used.After the blocking effect is determined,In addition to the decrease in arterial blood pressure, venous tone is also reduced.The tension in the heart can also decrease.
commonly used 500 mg plus 500 ml 10% glucosel?sung,Intravenous?this drop under close blood pressure monitoring,Usually 1 ~ 5mg / min.May cause water and sodium retention,Therefore, diuretics should be added to drugs for more than 24 hours.Continuous intravenous?This drop can lead to urinary retention or intestinal obstruction.Especially ?elderly people.Using laxatives can help prevent constipation.Cholinergic drugs are also effectiveOften orthostatic hypotension,Due to many side effects,And drug resistance easy to develop,It is rarely used now.
Phentolamine is a beta adreno blocker.Do you mainly expand?small arteries all over the bodyrper.Reduce peripheral vascular resistance,He?watch the cardiac output.But it can increase the heart rate.hen,Activate the renin-angiotensin-aldosterone system.In patients with a hypertensive crisis, the by receivedhte catecholamines or a decrease in heart and kidney functionParticularly suitable for patients with Ph?ochromocytoma.
H?Frequently used 10 mg plus 10% glucose 20 ml intravenously?se injection,Press 0 after blood pressure has dropped.1 ~ 2.0 mg / min intravenously?s.The antihypertensive effect is rapid,However, the half-life is short.The effects lasted less than 15 minutes after the drug was discontinued.The effect on β adrenergic,Phentolamine is not effective.Have tachycardiaBeta blockers k?can intravenous?s are administered.however,Patients with high levels of catecholamines k?Cannot use β-blockers alone.Otherwise only the alpha receptor activity remains?t left.The blood pressure will continue to rise sharply.Among the side effects z?cool tiredness, Dizziness and?deme.
Like low pressure magazine,Hydrazine lowers blood pressure by directly dilating small arteries.It can reflect increases in heart rate and cardiac output.Sometimes it can cause or worsen coronary dysfunction.Blood vessels expand in the internal organs,He?increase kidney blood flow.Suitable for acute and chronic glomerulonephritis with hypertensive encephalopathy or pregnancy lecampsia.
Application: The first 10 ~ 20 mg are given intravenously within 5 minutes?s injected.Then 100 mg plus 500 glucose?1000 ml continuous intravenous?this drop,Set the drip rate according to the blood pressure.The blood pressure starts after 10-15 minutes intravenously?water administration to decrease.After 30 minutes intramuscularly?After the injection it begins to fallDrug resistance occurs after several days of continuous use.Can the dose be increased?hen or add diuretics.
Oral 25 ~ 50mg / time,3 times t?resembled.Among the side effects z?hlen headache, Err?th, nausea, Vomit, receivedhigh heart rate, receivedhte myocardial?mie and lupus?Similar syndrome.
After methyldopa enters the center, it turns into α-methylnorepinephrine.The latter activates central α2 receptors,Do you reduce the peripheral vascular resistance and do you also act as a pseudo-medium for postganglion?ren nerve endings.Blocking adrenergic receptors that expand blood vessels: Also reduces the release of renin.It l?the blood pressure will dropWithout reducing kidney blood flow.Suitable for renal hypertension, pregnancy-induced hypertension syndrome,Delay?effect after intravenous?ser administration (4-6 hours),Hence its application in hypertensive emergencies.lln limited.
Should intermittent intravenous?se infusion (intermittent 30-60 minutes) dose of 250-1000 mg / time.The effect peak is reached 4 hours after oral administration,The effect h?lt 24 hours,H?Often used 0.25 ~ 0.50 grams per time,1 to 2 times a day.May cause water and sodium retention,It should be combined with diuretics.
Among the side effects z?hlen keysfriteness, Fatigue, Fever, Dry mouth, Depressions, Liver?the, Skin wounds, etc.Poor liver function, Ph?ochromocytoma, Parkinson’s disease are contraindicatedHypertensive encephalopathy and cerebral hemorrhage are also prohibited.
Nitroglycerin expanded mainly?the small veins of the whole kitchen?rpers.An intravenous?This infusion can also dilate small arteries.It dilates the coronary arteries,Reduce the oxygen consumption of the heart muscle.It is more effective than sodium nitroprusside for coronary artery insufficiency caused by high blood pressure.It is also effective in treating acute left heart failure.Intravenous?s,The effect is quick after stopping the drug,The effect is short-lived.commonly used 10-20 mg plus 500 ml 10% glucose,5 ~ 100 micrograms per minute intravenously?s,Adjust the drip rate based on blood pressure and condition.Among the side effects z?hlen headache, nausea and vomiting.
It can break down noradrenaline in the central hypothalamus and noradrenaline in sympathetic nerve endings.The antihypertensive effect is certainBut after intravenous?ser and intramuscular?rer injection,Blood pressure usually drops within 1 to 2 hours.Therefore, it cannot be used as an emergency medicine to lower blood pressure.H?Often used 1 ~ 2.5 mg / time,Can all?ugly increase.It can be used up to 5 ~ 10mg / timeBut rarely more than 10 mg / time,The total amount does not exceed 20 mg / day.The interval between every 2 doses is> at least 2 hours.After reaching the therapeutic amount,Available 2.5 ~ 5mg,Every 6-12 hours.
Side effects: long-term 10 mg / day or more,Can inhibit the brain marrow systemCause Parkinson’s Syndrome,It may go away after you stop taking the drug.May cause stomach ulcers and gastrointestinal bleeding.more important,Causes significant damagefriteness,Therefore, it is not suitable for cerebral hemorrhage and hypertensive encephalopathy.
The above antihypertensive drugs k?can be combined with diuretics, to increase the antihypertensive effecthen.Furosemide and Ethanilate Sodium are commonly usedBecause both intravenously?s be administered k?nnen,Quick results,And it’s still effective for kidney failure,Furosemide 40 ~ 80mg / time,Ethanans?ure sodium 50 ~ 100mg / time.The intravenous?This injection is effective in 1 ~ 5 minutes.Reach the top in 30 ~ 45 minutes,The effect h?lt 6 to 8 hours.At Azot?mieInject the above two drugs quickly and in large quantitiesen quantities.May cause neurological deafness.
Labetalol is an adrenergic alpha and beta blocker.No endogenous sympathomimetic activity?t.Blocking the use of alpha receptors decreases the perivascul?ren resistance.It can also decrease cardiopulmonary vascular resistance,Block beta receptors,Can the heart rate slow down and the contractility?t decrease the heart muscle.Suitable for hypertensive emergencieslle with angina pectoris,Intravenous?se application 50 mg plus 10% glucose 40 ml,One bolus injection of 5 mg / min,Can be repeated after 15 minutes,100 mg orally per time3 times t?resembled.Side effects are headache, Dizziness, nausea and hypotension,People with asthma shouldn’t use it.
Drug Selection for Hypertensive Emergencylle
What are the things about hypertension (WeChat ID: sangaook) I’ll summarize for everyoneContraindications, Which in Choosing Drugs for Hypertensive Emergency?all must be observedThe specific description is as follows.
1. Malignant hypertension
Selection of suitable drugs,Sodium nitroprusside, Low pressure magazine, Hydratrexin.
2. Hypertensive encephalopathy
Appropriate drug selection: sodium nitroprusside, Low pressure magazine, Campsulfame.
Disable or use drugs with caution: adrenergic inhibitors.
3. Acute intracranial hemorrhage
Appropriate drug selection: sodium nitroprusside, Campsulfame.
Disable or use drugs with caution: adrenergic inhibitors.
4th Acute left heart failure
Appropriate drug selection: sodium nitroprusside, Furosemide, Nitroglycerin, Campsulfame.
Drug, which should be prohibited or used with caution: low pressure hydrazine / hydralazine
5. Acute coronary insufficiency
Suitable drugs to choose from: nitroglycerin, Sodium nitroprusside.
Disable or use drugs with caution: hydrazine.
6. Acute aortic dissection
Appropriate drug selection: sodium nitroprusside, Campsulfame and adrenergic inhibitors.
Drugs prohibited or used with caution: hydrazine, Niederdruckazin
7th Renal hypertension and eclampsia
Appropriate drug selection: sodium nitroprusside, Low pressure magazine, Hydratrexin, Methyldopa.
Drugs prohibited or used with caution: campsulfame
8th. Caused by catecholamine allergy
Appropriate drug selection: phentolamine, Sodium nitroprusside.
Deactivate or use drugs with caution: adrenergic inhibitors.
Adrenergic inhibitors: propranolol, Metoprolol, Methyldopa, Clonidine, Reserpine, Guanethidine etc.