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***İLETİŞİM***
hipertansiyon acilde tedavisi

ANTIHYPERTENSIVE DRUGS FOR MANAGEMENT OF SEVERE HYPERTENSION IN CHILDREN

Most useful

Drug

Class

                        Comments

Esmolol

b-blocker

IV infusion

Very short-acting; constant infusion preferred. May cause profound bradycardia. Produced modest reductions in BP in a pediatric clinical trial.

Hydralazine

Vasodilator

IV, IM

Should be given every 4 hours when given IV bolus.
Recommended dose is lower than FDA label.

Labetalol

α- and β-blocker

IV bolus or infusion

Asthma and overt heart failure are relative contra indications.

Nicardipine

Calcium channel blocker

IV infusion

May cause reflex tachycardia.

Sodium nitroprusside

Vasodilator

IV infusion

Monitor cyanide levels with prolonged (>72 h) use or in renal failure; or coadminister with sodium thiosulfate.

IV, intravenous; BP, blood pressure; IM, intramuscular.

 

 

Treatment of Severe Hypertension

Severe hypertension may occur in children and adolescents. These patients will have stage 2 hypertension and some may have blood pressure substantially >99th percentile for age, sex, and height. These children frequently have a secondary underlying cause of their hypertension. This is a situation that requires prompt evaluation and treatment. The pharmacologic agents that are useful in the treatment of severe hypertension are presented in Table 75C.10. Pediatric patients may also present with hypertensive emergencies. In this situation the hypertension is often accompanied by hypertensive encephalopathy and possibly seizures. Such emergencies should be treated with an intravenous infusion that can produce a controlled reduction in blood pressure. It is recommended that the blood pressure be lowered by ≤25% in the first 8 hours with normalization over a 24- to 48-hour period

 

  
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