1. Rapid acting systemic and coronary artery vasodilator with minimal effects on cardiac conductivity or inotropy. Well studied in pregnancy. Caution in patients with left ventricular failure, liver cirrhosis
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Nicardipine2. Predominantly dilates the venous system. Useful in patients with cardiac ischemia, pulmonary edema, or congestive heart failure. Caution in patients with right ventricular failure
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Nitroglycerin3. Drug of choice in eclampsia, pre-eclampsia, and aortic dissection. Contraindicated in patients with congestive heart failure and heart block
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Labetalol4. Decreases peripheral vascular resistance and increases collateral coronary blood flow in an uncontrolled and unpredictable manner and may result in serious complications. Drug of choice during pregnancy
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Nifedipine5. Direct arterial vasodilator that increases cardiac output and heart rate (Reflex response). Patient may develop lupus like syndrome. Not to be used as first line in the ED
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Hydralyzine6. Arterial vasodilator that delays atrioventricular conduction and has a negative inotropic effect
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Verapamil7. Rapid onset of effect after oral administration (30 mins) with little change in cardiac output or reflex tachycardia. Adverse effect may include cough, angioedema. Toxic during first trimester
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Captopril8. Only for patients with subarachnoid hemorrhage. Not to be given IV only PO or NG tube
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Nimodipine9. The only parenteral angiotensin-converting enzyme inhibitor. May cause azotemia in older patients after MI
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Enalapril10. Oral or transdermal decreases peripheral vascular resistance. May cause sedation and bradycardia
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Clonidine11. Used in patients who are volume overloaded but not in patients who are hypertensive and volume depleted
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Diuretics12. Drug of choice for pheochromocytoma, MAOI crisis, and cocaine overdose
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PhentolamineReference:
1. Richard S. Irwin, James M. Rippe. Manual of Intensive Care Medicine; 4th ed
2. Marx: Rosen’s Emergency Medicine, 7th ed (Chapter 82- Hypertension: Richard O. Gray)
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