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Table 3: Antihypertensive treatment for urgent control in severe arterial hypertension. |
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Medication |
Dose |
Comment |
Onset of action (minutes) |
|
Labetalol |
10-20 mg IV, followed by 20-80 mg every 10-30 minutes to a maximum cumulative dose of 300 mg, or 1-2 mg/min IV infusion |
Avoid in women with asthma, myocardial disease, decompensated heart failure, advanced heart block, and bradycardia |
1-2 |
|
Hydralazine |
5 mg IV or IM, then 5-10 mg IV every 20-40 minutes up to a maximum cumulative dose of 20 mg, or infusion of 0.5-10 mg/hour |
Higher or more frequent doses are associated with maternal hypotension, headache, and abnormal fetal heart rate tracing |
10-20 |
|
Oral nifedipine (immediate release) |
10-20 mg PO, repeat in 20 minutes, if necessary, then 10-20 mg every 2-6 hours, maximum daily dose 180 mg |
Reflex tachycardia and headache as secondary effects |
5-10 |
|
IM = intramuscular; IV = intravenous; PO = orally. |
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