Hypertension, Over-the-Counter Medications, and Hypertensive Crises

Vocabulary practice flashcards covering over-the-counter medications that raise blood pressure, clinical definitions of hypertensive crises, and intravenous pharmacotherapy for hypertensive emergencies.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

A class of medications, including ibuprofen (Advil, Motrin) and naproxen (Aleve), that promote sodium retention and vasoconstriction, raising blood pressure by about $1\,\text{mm}\,\text{Hg}$ in nonhypertensive patients and by $5\text{ to }6\,\text{mm}\,\text{Hg}$ in hypertensive patients.

Acetaminophen

An over-the-counter analgesic agent considered a suitable alternative to NSAIDs because it does not elevate blood pressure to the extent that NSAIDs do.

Pseudoephedrine

A behind-the-counter oral nasal decongestant that increases blood pressure, causing greater blood pressure elevations with immediate-release formulations or higher doses.

Phenylephrine

A vasoconstrictor present in oral nasal decongestants and select over-the-counter hemorrhoidal products that can potentially raise blood pressure if systemically absorbed.

Hypertensive urgency

A condition characterized by severely elevated blood pressure (systolic $\ge 180\,\text{mm}\,\text{Hg}$ and/or diastolic $\ge 110\,\text{mm}\,\text{Hg}$) without acute ongoing target organ damage, typically managed using oral antihypertensive agents over $24\text{ to }48\,\text{hours}$.

Hypertensive emergency

A life-threatening condition marked by severely elevated blood pressure (typically systolic $\ge 180\,\text{mm}\,\text{Hg}$ and/or diastolic $\ge 120\,\text{mm}\,\text{Hg}$) accompanied by acute ongoing target organ damage, requiring blood pressure reduction within minutes via intravenous therapy.

Cerebral hypoperfusion

Inadequate blood flow to the brain that can cause brain injury if blood pressure is dropped too rapidly or excessively during the management of a hypertensive emergency.

Sodium nitroprusside

A short-acting intravenous medication that induces rapid arterial and venous vasodilation by releasing nitric oxide and directly stimulating guanylyl cyclase, with clinical effects dissipating within $1\text{ to }10\,\text{minutes}$.

Cyanide toxicity

A rare but reversible adverse effect associated with sodium nitroprusside administration due to the cyanide groups contained within the drug's chemical structure.

Danoldepam

A selective peripheral dopamine-1 receptor agonist administered via intravenous infusion that dilates peripheral, renal, and mesenteric arteries, increases renal blood flow, promotes diuresis and natriuresis, and is contraindicated in glaucoma.

Natriuresis

The renal excretion of sodium resulting in increased urine volume and elevated urinary sodium concentration.

Labetalol

An alpha-beta blocker used in hypertensive crises that exhibits a longer onset of action, longer half-life, and longer duration of action compared to agents like sodium nitroprusside.

Nicardipine

An intravenous calcium channel blocker used in hypertensive emergency that possesses a relatively long half-life, slower onset of action, and extended duration of action.

Esmol

A beta-1 selective blocker with rapid onset and a short half-life, specifically useful in a hypertensive emergency when the patient also presents with tachycardia.

Hydralazine

An arterial vasodilator that can be administered as an option for blood pressure lowering in hypertensive emergency.