2023 Pharmacology Update for APPs-Management of Hypertensive Crisis (Elisabeth Webb, PharmD)

Video Transcription

Video Summary

In this presentation, Elizabeth Webb, a Clinical Pharmacist Coordinator at the Shepherd Center in Atlanta, Georgia, discusses the management of hypertensive crisis. She begins by defining hypertensive urgency and emergency and outlining the treatment goals for each. Webb mentions that hypertension is divided into different stages and explains the diagnosis process. She then discusses the pharmacotherapy options for hypertension, emphasizing the need for combination therapy in most patients. Moving on to hypertensive crisis, Webb explains that it is characterized by acute and severe elevations in blood pressure, which can result in target organ damage. She lists possible causes of hypertensive crisis and outlines the potential target organ damages. Treatment goals for hypertensive urgency include gradually reducing blood pressure over 28 to 48 hours. For hypertensive emergency, a more aggressive blood pressure reduction is necessary, with specific goals for the first hour, hours 2 to 6, and hours 6 to 24. Webb emphasizes the importance of choosing the appropriate medication for blood pressure management based on factors such as comorbidities and the rate of target organ damage. She provides an overview of different classes of medications, including calcium channel blockers, vasodilators, beta blockers, and others. Webb also highlights the considerations for transitioning from intravenous to oral medications and the considerations for specific patient populations, such as pregnant women and patients with autonomic dysreflexia or paroxysmal sympathetic hyperactivity. In conclusion, Webb emphasizes the importance of following evidence-based guidelines and individualizing treatment based on the patient's specific needs and comorbidities.

Keywords

hypertensive crisis

hypertensive urgency

hypertensive emergency

treatment goals

pharmacotherapy options

target organ damage

medication selection