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Oral Antihypertensive Pharmokinetics - #PHARMFAX

Acutely lowering blood pressure for hypertensive urgencies is commonly done without strong evidence.

 


Acutely lowering blood pressure for hypertensive urgencies is commonly done without strong evidence. In cases that the number is being treated, we should still be familiar with the pharmacokinetics of oral antihypertensives to ensure safe monitoring parameters and administration.


Commonly used rapid-acting oral options include captopril, clonidine, labetolol, carvedilol, and nifedipine. Medication classes are listed above. The onset of these agents is within thirty minutes. Captopril is limited by renal insufficiency. Bradycardia exclude clonidine, labetolol, and carvedilol. Nifedipine immediate release isn't recommended due to severe hypotension. We don't want that happening.


Patients may also receive their home chronic medications for acute cases. Hydralazine, lisinopril, and diltiazem have an onset within an hour. Losartan and amlodipine have slow onset of actions, 6 and 48 hours respectively. I wouldn't expect seeing any acute changes. Caution in kidney impairment with lisinopril and losartan. Hydralazine may cause severe skin reactions. Being familiar with the kinetics gives you a sense of when to expect changes, especially before giving another antihypertensive or discharging patients.


For more #PHARMFAX in the drug bank, check out another video on my page, share the #PHARMFAX with a friend, and I hope you learned something new.

 

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