A hypertensive emergency is any condition in which the patient is suffering from a significant increase in blood pressure that can be life-threatening if not treated. Any patient who develops a blood pressure greater than 180 mmHg systolic or 110 mmHg diastolic is probably suffering from a hypertensive emergency, according to the American Heart Association. Once blood pressure has risen to such high levels, it can damage organs such as the kidney, eye, heart and brain. Treatment for these emergencies focuses on controlling the high blood pressure and minimizing the risk of lethal side effects.
Esmolol
Esmolol is a short-acting beta-adrenergic blocking drug that is very useful in reducing blood pressure, according to the "Critical Care Forum." This drug takes affect within 60 seconds after administration and lasts for 10 to 20 minutes. Esmolol is used to quickly reduce high blood pressure in patients who are in a hypertensive emergency. The drug can be used in patients with heart disease, such as those who have had a heart attack. Esmolol is available as an infusion or in an IV preparation.
Nifedipine
Nifedipine is a calcium-channel blocker that has proven effective in treating hypertensive crisis, reports the "Western Journal of Medicine." The drug causes arteries to dilate, and this significantly reduces the patient's blood pressure. Nifedipine can be given orally, under the tongue, or in the rectum. In any of these forms, the drug is able to produce a swift, predictable decline in blood pressure. By reducing blood pressure, nifedipine reduces the work of the heart, prevents the damage caused by extremely high blood pressure, and significantly decreases the chance of complications.
Nitroglycerin
Hypertensive emergencies can be treated with the drug nitroglycerin. Nitroglycerin is a nitrate drug that directly causes dilation of the arteries, states Drugs.com. The drug is commonly administered as a tablet that dissolves under the tongue or as an oral medication. The drug swiftly reduces blood pressure and any chest pain the patient may be experiencing. Nitroglycerin should not be taken repeatedly due to the risk of a precipitous drop in blood pressure. Side effects of nitroglycerin include dizziness, weakness, difficulty breathing, palpitation and a rash.
Nitroprusside
Nitroprusside can cause a significant decrease in both arterial and venous blood pressure, according to the "Critical Care Forum." This drug is very potent. It takes affect within seconds, but lasts for only one to two minutes. By significantly reducing blood pressure, this drug is useful in almost all types of hypertensive emergencies. However, in hypertensive emergencies that involve the brain, such as brain swelling or a stroke, nitroprusside is contraindicated. The drug reduces blood flow to the brain and causes an increase in pressure within the brain. Therefore, nitroprusside can be used in any hypertensive emergency, except those that involve the brain.
