The utility of bolus intravenous nicardipine for hypertensive emergencies in the ED

摘要

Nicardipine is a commonly used agent for the management of hypertensive emergencies due to its predictable pharmacokinetic profile and ease of titration. There is documented use of nicardipine administered as an intravenous (IV) bolus dose in several settings, particularly in the anesthesia literature. We describe the first 2 documented cases of use of nicardipine administered as an IV bolus dose in the emergency department (ED) for hypertensive emergencies involving acute ischemic stroke and hemorrhagic stroke. A literature review follows along with recommendations for consideration for IV bolus dosing of nicardipine in the ED. Overall, administration of nicardipine as an IV bolus dose may be effective for rapid short-term management of hypertensive crises in the ED setting.