clonidine for acutely lowering BP

[SCPA]

I don't see the point, yet I see it done often.. 

 

If the pt's bp is high in the clinic they need BP meds  started that day and pressure brought down over the next few days - weeks. Why give clonidine only to have them rebound later -- just so you can say they left with a good number? And if they are hypertensive with symptoms , they probably need to be shipped the the ER. 

 

Thoughts? What do you do in your practice?

[EMEDPA]

not a great idea. If they are symptomatic(as you said) they need to be in the ED. if they are not symptomatic, have them refill their meds or start an antihtn regimen. Even in the ED both this and sublingual nifedipine are not really used anymore. If someone acutely needs management of their htn crisis an IV agent like labetalol, hydralazine, or nitroprusside works better

[GetMeOuttaThisMess]

Back in the late 80's or early 90's in cardiology we used SL nifedipine on a sx. HTN pt. (elderly, and the doc them self administered the dose).  We got her pressure to normotensive levels with a minor complication, a significant neuro deficit as a result of her system now being in a "hypotensive state" for her.  Back at that time this was a perfectly acceptable treatment option (no, not the neuro deficit).  I couldn't count the number of capsules that I poked with a needle to squirt the med out sublingually.

[EMEDPA]

Back in the late 80's or early 90's in cardiology we used SL nifedipine on a sx. HTN pt. (elderly, and the doc them self administered the dose).  We got her pressure to normotensive levels with a minor complication, a significant neuro deficit as a result of her system now being in a "hypotensive state" for her.  Back at that time this was a perfectly acceptable treatment option (no, not the neuro deficit).  I couldn't count the number of capsules that I poked with a needle to squirt the med out sublingually.

yup, me too. don't do that anymore....