what i've learned from this video: 1- hypertension is when systolic blood pressure is more than 180mmHg or diastolic blood pressure is more than 120mm Hg 2- if there's end organ damage, it's hypertensive emergency , if the end organ damage is absent, it's hypertensive urgency 3- treatment of hypertensive urgency : control reduction of blood pressure. blood pressure is reduced over days not hours to prevent stroke which can be caused by sudden drop in blood pressure no ideal hypotensive but use oral atenolol along with bed rest 4- treatment of hypertensive emergency: either give iv labetalol 50mg iv over 1 min and repeat every 5 mins max dose is 200 mg or five sodium nitroproside infusion to control blood pressure 5- never use sublingual nifedipine to reduce blood pressure as rapid drop in blood pressure can cause stroke
Sir,i watched this video for HTN crisis management by IV NTG ,but unfortunately you didn't mentioned that.I have managed so many cases of HTN emergency with Labetalol and esmolol by iv bolus doses.I wanted to know the difference between both management procedures also.
Labetalol is a beta blocker ,when pt comes with hypertensive pulmonary edema there labetalol becomes contraindicated as it causes bronchospasm , whereas here iv NTG becomes drug of choice in this case,... So it's not about which anti htn to be used but any drug will have side effects n every case is different so u did not necessarily need to use one same drug for all the htn emergency cases
Not due to bronchospasm but because it can worsen heart failure symptoms as it will decrease cardiac contractility so to be avoided in acute settings @@Shin_Si
Sir , explained well and if you don’t mind please are you able to discuss all drug dosages and route of administration in your next videos ¿ it will be appreciated ,,, thanks in advance
Sir could you please explain the use of lasix in hypertensive emergency and urgency ? And is this right practice to use injection lasix for all hypertensive emergency and urgency
When the blood pressure is high brain has inhabited itself to high blood pressures. When you suddenly drop blood pressure to normal. Brain doesnot get the time to adjust its blood supply to lower pressures. So lesser blood supply to brain results in ischemic stroke. High BP + tachycardia = pick labetalol High BP + Bradycardia = Pick Nitroprusside
Sir good evening thanks for your lectures...sir why do pt develop stroke in both the cases in emergency and also in urgency.. please explain sir..I mean in emergency if pt had end organ damage as haemorrgic stroke..they how again pt get stroke in emergency if we reduce bp immediately...thank you sir
Very nice video sir. Kindly comment on confusion regarding use of sublingual ACEIs(i.e Captopril) as it is being used in our A&Es for hypertensive urgencies. Thank u
Sir, could you please help me ? I have left side intermittent chest pain since 2 days I got ecg I think in lead 2 there is mild st elevation ....caould I share with you my ecg.. Thank you🙏🙏🙏🙏🙏
Sir i want to know about old patients having copd and hypertension ...which drug is safe ...that is having least side effects ...can we go for labetelol .lasix or anvas or amlong ...sir plz let me know ...
Sir if pt. Is taking aspirin and rovista for mi 2 years back. And now presented in emergency with bp 210/210 .. ecg shows previous ischemic changes. Now this is emergency or urgency now ?
Assalam o Alaiqum sir Is Amlodipine long acting calcium channel blocker or short acting calcium channel blocker? Plz tell me Mera ye confusion door kar dijiye plz
Hi 👋 thank you for your video much appreciated from a student. Could you /anyone here give me some advice on a case. 31y/o female presents with chest pain and SOB. Sats are good at 98%, pulse 110 BP 202/112 Initial blood work was fine at her GP earlier that day. ECG normal. Medication-she is taking lithium. What is your thought on hypertension in this case with normal bloods(we will repeat as was 12 hours ago) so this would be urgent hypertension but she is having chest pain so that would make it crisis? Sorry if this seems stupid for a first year but I am a little confused with vitals elevated and bloods normal. I know with angina troponin is only seen in around half patients ? Bloods can increase from initial test after 12 hours right? I appreciate any help thank you
@@drfarhatjabeen5806 thank you Dr for your reply. Yes exactly but that’s the only thing that she takes medication wise the medication would not elevate the BP. Any suggestions on extra test / ideas you would do is this case ? Thanks again much appreciated from a student 😊
In a phc setup. Htn urgency. Why can't u give oral nifedipine. ? Pls explain. Not sublingual am saying oral. Secondly wat is the DOC. For htn urgency.. is it atenolol + amlong ?
Nifedipine oral with mannitol infusion to prevent from stroke.. Atenolol is started first then we add other drugs like ace, diuretics, calcium channel blockers as a routine practice if BP is uncontrollable
what i've learned from this video:
1- hypertension is when systolic blood pressure is more than 180mmHg or diastolic blood pressure is more than 120mm Hg
2- if there's end organ damage, it's hypertensive emergency , if the end organ damage is absent, it's hypertensive urgency
3- treatment of hypertensive urgency : control reduction of blood pressure. blood pressure is reduced over days not hours to prevent stroke which can be caused by sudden drop in blood pressure
no ideal hypotensive but use oral atenolol along with bed rest
4- treatment of hypertensive emergency: either give iv labetalol 50mg iv over 1 min and repeat every 5 mins max dose is 200 mg or five sodium nitroproside infusion to control blood pressure
5- never use sublingual nifedipine to reduce blood pressure as rapid drop in blood pressure can cause stroke
Nice summary
Hypertension grade 1 starts from 140/90..180/120 is hypertensive crisis which is an emergency situation
When he starts with ..." Okay"🤩
Your all videos are a great help for us , they way you present and the stuff all are very nice precise and wisely chosen, thanks v.much 😊
Thanks sir
Only clinical stuff 🔥 no deep theory like other boring videos.
👍👍👍
Thank you Vishal Singh. Very nice of you 😊
THANKS ALOT🙏🙏GOD BLESS YOU, I WAS HERE STRUGGLING TO REDUCE MY SISTERS' BP WHICH IS 200/140, THE VIDEO HAS HELPED ME ALOT!!!
Very well explained, short and comprehensive. Thank you!
JazakAllah sir
Very well explained ❤
Easy understandable. Thanks for making simpler.
Sir please make vedio on dose titration in both diebetes and blood pressure
Thank you for your efforts sir 🙏
Amazing classes👌🏻👌🏻👌🏻👌🏻
Omg…… I’m super impressed!! Sir you are indeed an amazing teacher…..😅😅🤩🤩
Thank you Aayushi sonkar for your kind words. 😊
Sir,i watched this video for HTN crisis management by IV NTG ,but unfortunately you didn't mentioned that.I have managed so many cases of HTN emergency with Labetalol and esmolol by iv bolus doses.I wanted to know the difference between both management procedures also.
Labetalol is a beta blocker ,when pt comes with hypertensive pulmonary edema there labetalol becomes contraindicated as it causes bronchospasm , whereas here iv NTG becomes drug of choice in this case,... So it's not about which anti htn to be used but any drug will have side effects n every case is different so u did not necessarily need to use one same drug for all the htn emergency cases
@@Shin_Si Thank you Ma'am
Iv ntg and sod nitroprusde infusions rate??
@@gautamsinghv5541BP will decide I think? 🤔
Not due to bronchospasm but because it can worsen heart failure symptoms as it will decrease cardiac contractility so to be avoided in acute settings @@Shin_Si
Nice explanation sir..ty so much for making topics easy to understand 😊
You're welcome divya teza. 😊
Sir your start with okay is very cool😅😅
Sir , explained well and if you don’t mind please are you able to discuss all drug dosages and route of administration in your next videos ¿ it will be appreciated ,,, thanks in advance
In ur videos please include dose
Awesome video, clear and short, thank you!
Most loved video from my heart❤️❤️
Thank you very much for your love and support 😊
Excellent teaching ,thank you sir !
Very very nice👍👍👍👍👍👍👍👍
Sir thankyou for the video .....
Very nicely presented. Easy to remember. I liked it. Hope everyone will like it too. Thank you so much, Sir.
So nice of you 😊
Thank you . But what alternate tablets if hospital is too far
Thank you very much sir nicely explain everything
VERY GOOD VIDEO. PLEASE MAKE VIDEO ON FLACTUATION OFBLOODPRESSURE..IT MANGEMENT.
Sure I will. 😊
Superb lecture. Kindly add doses of the drugs as well.
Sure Farzana I will. 😊
I usually use catapress sublingual my blood pressure always is too high 230/12
230/120
Nice presentation. Easily understandable. But i have a question,
"Can we use ACE inhibitor for hypertensive urgency? "
Yes captopril can be used
Superb explanation 👍
helped me greatly, thank you
Very good explanation sir...
Good concise presentations
It’s so useful sir ❤️
Thanks dr very useful
JAZAKALLAH..
Sir could you please explain the use of lasix in hypertensive emergency and urgency ? And is this right practice to use injection lasix for all hypertensive emergency and urgency
You can use lasix in case of volume overload status like hypertensive pulmonary oedema
U think lasix if there excess fluid in ur body! I
Great sir..
Very nicely topic is covered, thank you- Dr A K Singh
Thank you Dr. A K Singh. 😊
wonderful presentation. ❤
V nice sir...tq....
Thanks Doc, very useful info.
Great , thankyou sir.
You're welcome Krati Sharma. 😊
Helpful for residents👍
Sir awesome video
Doctor you give me Rizwan Sajan vibes
Thanks great explanation
Very good sir.
Some doctors use lasix in urgency hypertension? It is safe do lasix fast hypotensive drug?
Mind blowing teaching style sir
Hi Dr, Excellent work.
May you please make videos:1)neuro ophthalmology emergencies,
2)heart murmurs, and
3)thrombocytopenia.Njokweni(south africa)
Sure I will. 😊
Thank you so much sir❤
I like the approach Dr.
How does a sudden BP drop cause stroke?
How do you choose labetalol or sodium nitroprusside?Njokweni (south africa)
When the blood pressure is high brain has inhabited itself to high blood pressures. When you suddenly drop blood pressure to normal. Brain doesnot get the time to adjust its blood supply to lower pressures. So lesser blood supply to brain results in ischemic stroke.
High BP + tachycardia = pick labetalol
High BP + Bradycardia = Pick Nitroprusside
Thnq sir 🎉
Sir good evening thanks for your lectures...sir why do pt develop stroke in both the cases in emergency and also in urgency.. please explain sir..I mean in emergency if pt had end organ damage as haemorrgic stroke..they how again pt get stroke in emergency if we reduce bp immediately...thank you sir
But sir according to text book drug of choice for hypertensive urgency is clonidine
You didn’t explain how to give NTG ?
How much ml / min ?
Is that plane NTG / should we dilute with NS ?
What is the dose of sodium nitroprusside for infusion?
Very nice lecture
Sirji PHC aur RH par jyadatr cap depin sublingual use karte hai...jo ki aapne never use nifidepin bataya hai....kaise karneka...
Look for any risk factors of stroke?? Handle as that.. U can give mannitol infusion along with that if possible
Very nice lesson, thank you sir, i followed you all
Amazing lecture
Sir Inj. Labetalol 50 mg iv or 20 mg iv ?
Sir plz give us some knowledge of emergency in paediatric patients
Can we use captopril sublingually to hypertension urgency?
Is there any channel for obs and gynae clinical knowledge and treatment pls suugest
In hypertensive urgency ..can we give ACE inhibitor in less than 55 year as CMDT said
ACE inhibitors cause precipitous fall in blood pressure and therefore should be avoided in patients who are hypovolemic.
AOA sir hypertension ki wajah say meray room mate ko khooni bawaseer ho gya hay kindly treatment bta den.Bundle of thanks.
Very nice video sir. Kindly comment on confusion regarding use of sublingual ACEIs(i.e Captopril) as it is being used in our A&Es for hypertensive urgencies. Thank u
Captopril PO 26mg stat works great
Onset of action is within 15-20 mins
Can be used for htn urgency
Written in CMDT medicine
I think any antihypertensive drug works it all depends on how patients are responding and keeping check of side effects and contraindications of drugs
Sir.,
When did i use sublingual drugs to control high blood pressure
Sir, could you please help me ? I have left side intermittent chest pain since 2 days I got ecg I think in lead 2 there is mild st elevation ....caould I share with you my ecg..
Thank you🙏🙏🙏🙏🙏
Jio Life, you may email it to me on "docwaqasfazal@gmail.com". Please also share your age with it.
Thank you sir 👏
What is the dose of oral atenolol in hypertensive urgency
sir plz make vedios on how to read xray .
Sir i want to know about old patients having copd and hypertension ...which drug is safe ...that is having least side effects ...can we go for labetelol .lasix or anvas or amlong ...sir plz let me know ...
what about malignant hypertension? is it the same as hypertensive urgency?
Thank you
👌👌👌👌👌👌
Sir if pt. Is taking aspirin and rovista for mi 2 years back. And now presented in emergency with bp 210/210 .. ecg shows previous ischemic changes. Now this is emergency or urgency now ?
Plz tell us about gynaecology obs emergency
Assalam o Alaiqum sir
Is Amlodipine long acting calcium channel blocker or short acting calcium channel blocker?
Plz tell me
Mera ye confusion door kar dijiye plz
Amlodipine is long acting calcium channel blocker.
Sir,can we advice for IV drips in case of hypertensive urgency ?
Can we use s.l .isosorbide di nitrate
Sir I'm struggling against ibs d last 24 years and I'm so skinny so plz tell can ibs d cause weight loss ?
Thanks sir
❤️
Hi 👋 thank you for your video much appreciated from a student. Could you /anyone here give me some advice on a case. 31y/o female presents with chest pain and SOB. Sats are good at 98%, pulse 110 BP 202/112 Initial blood work was fine at her GP earlier that day. ECG normal. Medication-she is taking lithium. What is your thought on hypertension in this case with normal bloods(we will repeat as was 12 hours ago) so this would be urgent hypertension but she is having chest pain so that would make it crisis? Sorry if this seems stupid for a first year but I am a little confused with vitals elevated and bloods normal. I know with angina troponin is only seen in around half patients ? Bloods can increase from initial test after 12 hours right? I appreciate any help thank you
Essential hypertension nothing to do with lithium
@@drfarhatjabeen5806 thank you Dr for your reply. Yes exactly but that’s the only thing that she takes medication wise the medication would not elevate the BP. Any suggestions on extra test / ideas you would do is this case ? Thanks again much appreciated from a student 😊
Excellent
Thank u sir 🙏
Thank you boss
❤❤❤❤
Thank you sir
NICE VIDEO
🙏🏻🙏🏻
Thanks
Can we use sublingual captoptril ?
No
Sir your lectures are excellent , how can I get your all the lectures in USB or other way??
I am a Pharmacist, can any mention any Intresting channel about Clinical Pharmacy
In a phc setup. Htn urgency. Why can't u give oral nifedipine. ? Pls explain. Not sublingual am saying oral.
Secondly wat is the DOC. For htn urgency.. is it atenolol + amlong ?
Nifedipine oral with mannitol infusion to prevent from stroke.. Atenolol is started first then we add other drugs like ace, diuretics, calcium channel blockers as a routine practice if BP is uncontrollable
🙏🏻🙏🏻🙏🏻🙏🏻🙏🏻🙏🏻
Nice
🙏🏻🙏🏻🙏🏻🙏🏻🙏🏻❤❤❤❤❤❤
Sir. What about diuretics in HTN??
My dil garden garden hogeya sir
Hahaha thank you Barad. 😊