Hypertensive Emergencies and Urgencies

Evaluation of the Method for Nifedipine Administration for a Rapid Onset of Clinical Effect: A Clinical Study in Normal Volunteers.

“…However, nifedipine is still widely used for treatment of emergency, especially pseudoemergency hypertension, because it has been said that it has rarely induced excessive hypotension and has had no serious side eŠects. 13) Brown et al 14) compared sublingual administration of nifedipine with oral administration and reported that the increase in the serum nifedipine concentration was more rapid by the sublingual administration. On the other hand, there have been reports that nifedipine was not almost absorbed through the oral mucosa, and sublingual nifedipine was not eŠective.…”

Oral Nifedipine vs Oral Clonidine in the Treatment of Urgent Hypertension

“…which severe elevation of blood pressure results in acute end-organ damage and represents an acute threat to vital organs or to the patient's survival, and (2) hypertensive urgencies, in which severe elevation of blood pressure represents a potential immediate threat, but no acute endorgan damage is present.…”

Control of hypertensive emergencies

“…the mean arterial pressure is lowered below 120 mm Hg. 4 The implication is that the autoregulatory mechanism (see box on page 112) may have been reset in patients who have long-standing hypertension and is therefore less sensitive to any rapid changes in blood pressure. In patients with cerebral atherosclerosis, especially the elderly, the risk of cerebral ischemia may be even greater.…”

“…4 The onset of action of captopril (Capoten) given orally occurs in 30 to 60 minutes. Teprotide, the active metabolite of enalapril maleate (Vasotec), is now available for intravenous use.…”