Podcast 592:  Rapid Antihypertensives

Podcast 592: Rapid Antihypertensives

Contributor: Ramnik Dhaliwal, MD, JD

Educational Pearls:

  • Nitrates
    • Nitroprusside: becomes effective in under a minute, and becomes ineffective 10 minutes after stopping it.
      • Nitroprusside can metabolize into cyanide leading to toxicity, however this is rare.
    • Nitroglycerin: predominately causes vasodilation but some arterial dilation as well; preferred agent in patients with volume overload/CHF
  • Adrenergic Blocking Agents
    • Labetalol: alpha/beta-blocking agent with a rapid onset of 5 minutes or less given as bolus or intravenous drip
    • Esmolol: cardioselective beta blocker with rapid onset and short duration of action making it easily titratable
    • Hydralazine: direct arterial dilator; patient dependent response that can be unpredictable. Use with caution in patients with CAD or an aortic dissection because there will be a reflexive increase in heart rate to combat the arteriolar dilation.
  • Calcium Channel Blockers
    • Nicardipine: Given as an IV infusion starting at 5g/hr up to 15g/hr. This drug has a slower onset of action making it difficult to titrate and it has a longer serum elimination half-life (3-6 hours)
    • Clevidipine: rapid onset and short duration of action; Reduces BP without affecting cardiac filling pressures but can cause reflex tachycardia

References

)Wani-Parekh P, Blanco-Garcia C, Mendez M, Mukherjee D. Guide of Hypertensive Crisis Pharmacotherapy. Cardiovasc Hematol Disord Drug Targets. 2017;17(1):52-57. doi:10.2174/1871529X16666161220142020

Suneja M, Sanders ML. Hypertensive Emergency. Med Clin North Am. 2017;101(3):465-478. doi:10.1016/j.mcna.2016.12.007

Maloberti A, Cassano G, Capsoni N, et al. Therapeutic Approach to Hypertension Urgencies and Emergencies in the Emergency Room. High Blood Press Cardiovasc Prev. 2018;25(2):177-189. doi:10.1007/s40292-018-0261-4

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD



Avsnitt(1146)

On the Streets #5: Trauma during COVID-19

On the Streets #5: Trauma during COVID-19

Jordan sits down to discuss trauma with Dr. Kaysie Banton, the Trauma Services Medical Director at Level 1 Trauma Center Swedish Medical Center in Englewood, Colorado. In this laid back interview, Dr....

20 Maj 202026min

Podcast 564:  Cardiac Ischemia Management Update

Podcast 564: Cardiac Ischemia Management Update

Contributor: Nick Tsipis, MD Educational Pearls: Recent randomized controlled trial compared early intervention (PCI/CABG) to medical management for those diagnosed with moderate to severe cardiac is...

19 Maj 20205min

Podcast 563:  DC ACs

Podcast 563: DC ACs

Contributor: Nick Hatch, MD Educational Pearls: An AC (acromioclavicular joint) separation in the shoulder is a common traumatic injury XRs can help rule out other injuries as well as help with gradi...

18 Maj 20202min

COVID-19 Digest: Could Cigarette Smoking Actually be Protective Against COVID?

COVID-19 Digest: Could Cigarette Smoking Actually be Protective Against COVID?

Host: Elizabeth Esty, MD. Smoking is known to increase both susceptibility and severity of all manner of colds and pneumonias, so you'd think the world's 1.1 billion smokers would be at risk in this p...

13 Maj 202018min

Podcast 562:  COVID-19 Occlusions

Podcast 562: COVID-19 Occlusions

Contributor: Nick Tsipis, MD Educational Pearls: Case series reported 5 cases of generally young and healthy patients with COVID-19 who presented to the ER with acute stroke Now several case series s...

12 Maj 20202min

Podcast 561:  Give Bup

Podcast 561: Give Bup

Contributor: Don Stader, MD Educational Pearls: Buprenorphine has been shown to decrease morbidity and mortality in opioid use disorder Buprenorphine used in naloxone-induced withdrawals can displace...

11 Maj 20204min

COVID-19 Digest: Bacille Calmette-Guérin (BCG) Vaccine for Treating COVID-19

COVID-19 Digest: Bacille Calmette-Guérin (BCG) Vaccine for Treating COVID-19

In the US, few people receive vaccination for tuberculosis (TB), a disease that hasn't been a major killer here for many decades. But while we in the US mostly experience TB as a relatively rare but ...

8 Maj 202014min

Podcast 560:  Imaging in a COVID world

Podcast 560: Imaging in a COVID world

Contributor: Don Stader, MD Educational Pearls: COVID-19 commonly appears as a bilateral patchy infiltrate on chest radiograph, but this is a non-specific finding Sensitivities range from 17-70% f...

7 Maj 20206min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
rss-ufo-bortom-rimligt-tvivel
det-morka-psyket
rss-vetenskapsradion
medicinvetarna
rss-vetenskapsradion-2
rss-experimentet
sexet
hacka-livet
rss-spraket
dumforklarat
pojkmottagningen
rss-arkeologi-historia-podden-som-graver-i-vart-kulturlandskap
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
halsorevolutionen
paranormalt-med-caroline-giertz