II. Indications
- First-line management of Hypertensive Emergency (Hypertensive Crisis)
- Preferred over Labetalol, Nitroglycerin Drip, and Nitroprusside
- Use Esmolol in Hypertensive Crisis if Heart Rate control is needed (e.g. AAA or Aortic Dissection)
III. Mechanism
- Second Generation Dihydropyridine Calcium Channel Blocker
- Pure arterial vasodilation
- Decreases Blood Pressure
- Does not effect Heart Rate or Preload
IV. Dosing
- Start: 5 mg/hour
- Maximum: 15 mg/hour
- Titrate
- Increase by 2.5 mg/hour every 5-15 minutes until Blood Pressure goal reached or maximum reached (15 mg/hour)
- Once goal Blood Pressure achieved, titrate down towards 3 mg/hour as long as Blood Pressure is controlled
V. Adverse Effects
VI. References
- Orman and Weingart in Majoewsky (2012) EM:RAP 12(2): 6-7