Table 5-5. Some drugs used in hypertensive emergencies.
Presc Cat contains the controlled drug
and FDA pregnancy safety category codes
To calculate dose for over/underweight patients:
(Trade names) Dose Onset Duration Pres
Diazoxide (Hyperstat IV: 300 mg/20 mL amp) Rx;C
IV 1-3mg/kg Q5-15min 4-6hr
"minibolus" 150 mg maximum in a single injection. 1
Nifedipine (Adalat, Procardia: 10 mg caps) Rx;C 2
Sublingual 10-20 mg 5-10min 4hr
Nitroprusside (generic, Nipride: 50 mg/vial) Rx;C
IV 0.5-10 ug/kg/min 30 sec 1-5min 3
Trimethaphan (Arfonad: 500 mg/10 mL amp) Rx;X
IV 3-4mg/min 1-2min 10-30min
1. Manufacturer's literature recommends rapid administration -- in 30 sec-
onds or less -- but excessive lowering of pressure is much less common if
administration is slower (over several minutes).
2. Unlabeled use. Puncture capsule several times with needle, place under
3. Nitroprusside is unstable once dissolved in IV fluid. Protect from light
and discard after 24 hr. Average dose is 3 ug/kg.min. Rate of administra-
tion should not exceed 10 ug/kg.min to avoid excessive serum cyanide
levels. If satisfactory reduction of blood pressure is not achieved within
10 minutes at this rate, additional drugs should be added or substituted.