62  Anti-Hypertensive Medications

62.1 Things to know

  • Amlodipine takes about 30 hours to take effect
  • Captopril works for about 8 hours
  • Furosemide can probably be given to patients with sulfa allergies, but there is risk for cross-reactivity (~10%)
  • There is no standard way to taper clonidine and no consensus has been reached on length of taper
  • Eye drops can be absorbed systemically and are often used without proper instructions
  • Systemic absorption occurs when fluid drains into the vascular nasal mucosa via the lacrimal duct (a process promoted by blinking). Mitigate this by telling patients to close their eyes for 2-3 minutes after administration
  • Beta-blockade prevents nitroprusside-induced reflex tachycardia, thereby decreasing shear stress on the aorta
  • CKD is not a contraindication to use of nitroprusside (cyanide toxicity does not occur until at least 24 to 48 hours after initiation of the medication)