Management of Severe Hypertension in Patients Presenting with Vomiting
1. Assessment for Hypertensive Emergency
2. When No Acute Target‑Organ Damage Is Identified (Most Common Scenario)
3. Management If Acute Target‑Organ Damage Is Present (Hypertensive Emergency)
4. Critical Pitfalls to Avoid
5. Specific IV Regimens for Confirmed Hypertensive Emergencies
| Medication | Initial Bolus / Starting Dose | Continuous Infusion (titration) | Maintenance Dose | Onset | Duration |
|---|---|---|---|---|---|
| Labetalol | 0.25–0.5 mg/kg IV bolus | 2–4 mg/min IV infusion until target BP, then 5–20 mg/h maintenance | 5–20 mg/h | 5–10 min | 3–6 h |
| Nicardipine | 5 mg/h IV infusion (no bolus) | Increase by 2.5 mg every 15–30 min until goal BP; then reduce to 3 mg/h maintenance | 3 mg/h | 5–15 min | 30–40 min |