What is the preferred management for hypertensive emergency due to an adrenergic crisis (e.g. cocaine use or phaeochromocytoma)?

{{c1::Phentolamine}}

What is the preferred management for hypertensive emergency due to an adrenergic crisis (e.g. cocaine use or phaeochromocytoma)?<br><br>{{c1::Phentolamine}}

Consider using an intravenous dose of hydralazine as an interim measure until phentolamine is available. If phentolamine is not available, consider using an intravenous infusion of sodium nitroprusside. Benzodiazepines can be a useful adjunct to BP-lowering therapy in adrenergic crisis, as they can reduce catecholamine-induced tachycardia and hypertension. The anxiolytic and sedative properties of benzodiazepines are beneficial in an anxious patient or a patient whose behaviour is affected by stimulant use.

Beta-blocker monotherapy is contraindicated in adrenergic crisis as it may cause an extreme rise in BP.

Consider using an intravenous dose of hydralazine as an interim measure until phentolamine is available. If phentolamine is not available, consider using an intravenous infusion of sodium nitroprusside.&nbsp;Benzodiazepines can be a useful adjunct to BP-lowering therapy in adrenergic crisis, as they can reduce catecholamine-induced tachycardia and hypertension. The anxiolytic and sedative properties of benzodiazepines are beneficial in an anxious patient or a patient whose behaviour is affected by stimulant use.<br><br>Beta-blocker monotherapy is contraindicated in adrenergic crisis as it may cause an extreme rise in BP.

<img src="54fcafa50b411134b06d7a0ede60f70d.webp"><br><img src="85f705e5122a8e16d6eada857ed0fd18.webp"><br><img src="601d0fb7271a73d22c74107a68e2c4b2.webp">

eTG - Urgent control of elevated blood pressure https://tgldcdp.tg.org.au/viewTopic?etgAccess=true&guidelinePage=Cardiovascular&topicfile=c_CVG_Urgent-control-of-elevated-blood-pressuretopic_1&guidelinename=auto&sectionId=c_CVG_Urgent-control-of-elevated-blood-pressuretopic_1#c_CVG_Urgent-control-of-elevated-blood-pressuretopic_1 Published June 2023, Accessed 19 October 2024

eTG - Urgent control of elevated blood pressure <a href="https://tgldcdp.tg.org.au/viewTopic?etgAccess=true&amp;guidelinePage=Cardiovascular&amp;topicfile=c_CVG_Urgent-control-of-elevated-blood-pressuretopic_1&amp;guidelinename=auto§ionId=c_CVG_Urgent-control-of-elevated-blood-pressuretopic_1#c_CVG_Urgent-control-of-elevated-blood-pressuretopic_1">https://tgldcdp.tg.org.au/viewTopic?etgAccess=true&amp;guidelinePage=Cardiovascular&amp;topicfile=c_CVG_Urgent-control-of-elevated-blood-pressuretopic_1&amp;guidelinename=auto&amp;sectionId=c_CVG_Urgent-control-of-elevated-blood-pressuretopic_1#c_CVG_Urgent-control-of-elevated-blood-pressuretopic_1</a> Published June 2023, Accessed 19 October 2024