II. Indications

  1. First-line management of Hypertensive Emergency (Hypertensive Crisis)
    1. Preferred over Labetalol, Nitroglycerin Drip, and Nitroprusside
    2. Use Esmolol in Hypertensive Crisis if Heart Rate control is needed (e.g. AAA or Aortic Dissection)

III. Mechanism

  1. Second Generation Dihydropyridine Calcium Channel Blocker
  2. Pure arterial vasodilation
  3. Decreases Blood Pressure
  4. Does not effect Heart Rate or Preload

IV. Dosing

  1. Start: 5 mg/hour
  2. Maximum: 15 mg/hour
  3. Titrate
    1. Increase by 2.5 mg/hour every 5-15 minutes until Blood Pressure goal reached or maximum reached (15 mg/hour)
    2. Once goal Blood Pressure achieved, titrate down towards 3 mg/hour as long as Blood Pressure is controlled

V. Adverse Effects

VI. References

  1. Orman and Weingart in Majoewsky (2012) EM:RAP 12(2): 6-7

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