82
Complications of Management
Table 26. Intravenous Antihypertensive Drugs for Treatment
of Hypertensive Emergencies
Class Drug(s) Usual Dose Range
Adrenergic
blockers
Combined
alpha-1 and
nonselective
beta receptor
antagonist
Labetalol Initial 0.3–1.0-mg/kg dose (maximum 20 mg ) slow
IV injection every 2 min or 0.4–1.0-mg/kg/h IV
infusion up to 3 mg/kg/h. Adjust rate up to total
cumulative dose of 300 mg/24 hours.
Adrenergic
blockers
Nonselective
alpha receptor
antagonist
Phentolamine IV bolus dose 5 mg. Additional bolus doses every 10
min as needed to lower BP to target. Adjust rate up
to total cumulative dose of 50 mg/24 h.
Dopamine-1
Receptor
selective agonist
Fenoldopam Initial 0.1–0.3 mcg/kg/min; may be increased in
increments of 0.05–0.1 mcg/kg/min every 15 min
until target BP is reached. Maximum infusion rate
1.6 mcg/kg/min.
ACE inhibitor Enalaprilat Initial 1.25 mg over a 5-min period. Doses can be
increased up to 5 mg every 6 h as needed to achieve
BP target. Adjust rate up to total cumulative dose of
50 mg/24 h.
MI, myocardial infarction.
Modified with permission from Whelton et al. Copyright © 2018 American College of
Cardiolog y Foundation and American Heart Association, Inc.
(cont'd)
