High Stakes, High Pressure: Managing Hypertensive Crisis

After completing this application-based continuing education activity, pharmacists will be able to

• DESCRIBE the key differences between severe hypertension and hypertensive emergency

• RECOGNIZE the appropriate treatment strategies for those with a hypertensive crisis

• IDENTIFY the importance comorbidities play in hypertensive emergency and their corresponding preferred treatment

After completing this application-based continuing education activity, pharmacy technicians will be able to:

• DESCRIBE the key differences between severe hypertension and hypertensive emergency

• IDENTIFY strategies to reduce dispensing and preparation errors with high-risk antihypertensive medications

• RECOGNIZE common dosing ranges and administration routes for medications used in severe hypertension and hypertensive emergencies

The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy and Pharmaceutical Sciences or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

CE title: High Stakes, High Pressure: Managing Hypertensive Crisis
26-014 Pharmacist Post-Test

Learning Objectives:
1. Describe the key differences between severe hypertension and hypertensive emergency
2. Recognize the appropriate treatment strategies for those with a hypertensive crisis
3. Identify the importance comorbidities play in hypertensive emergency and their corresponding preferred treatment

1) Which of the following distinguishes hypertensive emergencies from severe hypertension?
a) Systolic blood pressure > 180 mmHg
b) Diastolic blood pressure > 120 mmHg
c) Presence of acute organ damage

2) Which of the following IV mediation is recommended as the initial therapy for a hypertensive emergency in acute aortic dissection?
a) Hydralazine 10 mg IV push
b) Nitroprusside 0.3 mcg/kg/min IV infusion
c) Esmolol 500 mcg/kg loading dose, followed by 50 mcg/kg/min IV infusion

3) Which antihypertensive would you recommend to reduce BP in a patient who is a candidate for reperfusion therapy in an acute ischemic stroke?
a) Nitroglycerin 5 mcg/min IV infusion
b) Nicardipine 5 mg/hour IV infusion
c) Enalaprilat 1.25 mg IV push

4) Which of the following medications can be used for hypertensive emergencies induced by catecholamine excess?
a) Phentolamine
b) Hydralazine
c) Esmolol

5) Which IV antihypertensive therapy requires lipid monitoring due to its formulation being made as a lipid emulsion?
a) Nicardipine
b) Clevidipine
c) Nitroprusside

6) Which IV antihypertensive therapy can cause cyanide and thiocyanate toxicity in patients with liver dysfunction or chronic kidney disease?
a) Sodium nitroprusside
b) Nitroglycerin
c) Labetalol

CE title: High Stakes, High Pressure: Managing Hypertensive Crisis
26-014 Pharmacy Technician Post-Test

Learning Objectives:
1. Describe the key differences between severe hypertension and hypertensive emergency
2. Recognize common dosing ranges and administration routes for medications used in severe hypertension and hypertensive emergencies
3. Identify strategies to reduce dispensing and preparation errors with high-risk antihypertensive medications

1. A patient has BP 210/118 mmHg and no signs of organ injury. How should this be classified?
A. Hypertensive emergency
B. Severe hypertension without organ damage
C. Stroke requiring thrombolysis

2. Which medication route is appropriate for initial treatment of hypertensive emergency in the ICU?
A. Oral immediate-release capsule
B. Intravenous infusion
C. Subcutaneous injection

3. Why are high-alert labels used on IV antihypertensive infusions?
A. To improve visual awareness and reduce selection errors
B. To speed up dispensing workflow
C. To eliminate the need for double-checks

4. Why are standardized concentrations recommended for IV antihypertensive infusions?
A. They reduce variability and decrease dosing errors
B. They allow technicians to change infusion rates
C. They increase medication shelf life

5. Which safeguard helps prevent dispensing the wrong antihypertensive medication formulation?
A. Barcode verification during dispensing
B. Memorizing medication shelf placement
C. Selecting medication by package color

6. Which of the following symptoms may indicate acute target organ damage in hypertensive emergencies?
A. Severe chest pain and/or shortness of breath
B. Nausea
C. Occasional muscle soreness

Learning Objectives

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CONTENT

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Pharmacist Post Test (for viewing only)

Pharmacy Technician Post Test (for viewing only)