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HYPERTENSI CRISIS
Merupakan keadaan yg ditandai
tekanan darah yang sangat tinggi
dengan kemungkinan akan timbulnya
atau telah terjadinya kelainan organ
Hypertensive
Urgencies
Emergencies and
Clinically,thesesituationscanbeclassifiedeitheras
EMERGENCYHYPERTENSION (HIPERTENSI
DARURAT)
URGENCYHPERTENSION
(HIPERTENSIMENDESAK)
HYPERTENSIVE EMERGENCY
Thetermhypertensiveemergencyisdefinedas
severehypertensionorasuddenincreaseinblood
pressurewithevidenceofacuteinjurytotarget
organs(eg,brain,heart,kidney,vasculature,and
retina.
Examplesincludemalignanthypertension,
hypertensiveencephalopathy,aorticdissection,
unstableangina,acutemyocardialinfarction,
eclampsia,pulmonaryedema,andacuterenal
failure.
Hypertensiveencephalopathy:papilledema,
headache,somnolence,confusion,stupor,
gastrointestinaltractdistress,visualloss,focal
neurologicdeficits,coma,andseizures
.Hypertensiiveemergencyrequiresubstantial
reductionofbloodpressurewithin1hourtoavoid
theriskofmorbidityordeath.
Itimpliestheneedforhospitalizationto
immediatelylowerbloodpressurewithparenteral
therapy.
The
HYPERTENSIVE URGENCY
Thetermhypertensiveurgencyisdefinedassevere
hypertensionwithoutevidenceofacutetargetorgan
injurybutoccurringinasettinginwhichitis
importanttodecreasebloodpressuretosaferlevels
overa24to48hourperiod.
Treatmentisadministeredorallyandhospitalization
usuallyisnotrequired.
PHARMACOLOGIC TREATMENT
(PARENTERAL AGENTS)
Nitroprusside sodium
Nitroglycerin,intravenous
Labetalol
Esmolol
Nicardipine
Fenoldopam
Enalaprilat
Diazoxide
Hydralazinde
Trimethapan
Diuretics
PHARMACOLOGIC TREATMENT
(ORAL AGENTS)
Clonidine
Captopril
Nifedifine
As
First-line antihypertensive
drugs
Diuretic
s
blockers
ACE
inhibitors
1
blockers
Ca
antagonists
Angiotensin II
antagonists
Combination Therapies
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