Ginkus-O'Connor N
Heart Lung. 1981 Sep-Oct;10(5):848-55.
Drugs used to treat hypertensive emergencies should have the characteristics of rapid action, short duration, high potency, reversibility, a low toxic/therapeutic ratio, no association tachyphylaxis, and a specific action on the cardiovascular system. Of the three mentioned only SNP fulfills all of the requirements. SNP is used, with few exceptions, to treat hypertensive crisis. Trimethaphan camsylate is useful in preventing hemorrhage secondary to a dissecting aneurysm; the other drugs may worsen the tear. Diazoxide is good when no prolonged monitoring is available, since the drug is administered as a bolus rather than an infusion. Side effects, contraindications, and drug interactions are important points to remember during administration of these medications. Care is directed toward limiting or avoiding side effects by titrating the drug and by close observation of the patient. Concurrent maintenance therapy must be initiated to prevent a recurrence of hypertension upon discontinuance of the acute drug protocol.
用于治疗高血压急症的药物应具备作用迅速、持续时间短、效力高、可逆性、毒性/治疗指数低、无快速耐受性以及对心血管系统有特异性作用等特点。上述三种药物中，只有硝普钠（SNP）满足所有这些要求。除少数例外情况，硝普钠用于治疗高血压危象。樟磺咪芬可用于预防夹层动脉瘤继发的出血；其他药物可能会使撕裂加重。当无法进行长期监测时，二氮嗪是适用的，因为该药物以大剂量推注而非静脉输注的方式给药。在使用这些药物期间，副作用、禁忌证和药物相互作用是需要牢记的重要要点。通过调整药物剂量和密切观察患者来注意限制或避免副作用。必须启动同时进行的维持治疗，以防止在停用急性药物方案后高血压复发。
