IV push antihypertensives are great tools to manage BP intermittently or bridge to titratable infusions.
IV push antihypertensives are great tools to manage BP intermittently or bridge to titratable infusions. Always be aware of the blood pressure goal as you’re selecting your agents and doses. Understanding the pharmacokinetics of the medications provides the best option for the patient’s acuity.
There’s two common IV push antihypertensives used; labetolol and hydralazine. Both have a dosing range of 5 to 20 mg every 10 minutes PRN in hypertensive emergencies. Labetolol is an alpha1 and nonselective beta blocker with an onset within 5 minutes. Duration can be 4 hours up to 18, which is dose-dependent. Consider other antihypertensives in bradycardic patients.
Hydralazine is a direct vasodilator unpredictable kinetics that minimal effects on HR. Onset can be rapid at 5 minutes or delayed up to 80 minutes IV. Thats gets you in trouble when you’re trying to aggresively lower BP and adminstering every 10 minutes, which isn’t as reliable of information compared to labetolol’s kinetics.
Its your only agent at times so consider these when choosing a patient-centered dose: how aggressive for the indication, what subsequent agents are accessible, and potential additive hypotensive-lowering agents. Did you share the #PHARMFAX? Check out another video on my page, and I hope you learned something new.
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