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Medicine Emergency Clinical Scenario dc8196af

In a patient with autonomic dysreflexia after a spinal cord injury, supine BP of the patient is 200/100 mm Hg with hea rate of 58/min. Which of the following is required for initial management of these patients?

A
Nicardipine
B
Sodium nitroprusside
C
Nitro-glycerine
D
Labetalol
High-Yield Explanation
Management of patient with supine hypeension : Placing him in sitting position and giving him a buccal spray of NTG (nitro glycerine) followed by NTG drip if required. Trigger for Autonomic Dysreflexia in patients of spinal cord injury is blocked or kinked Foley's catheter or stool impaction. Choice A (Nicardipine) is used in Hemorrhagic stroke with hypeensive crisis. Choice B (Sodium nitroprusside) in hypeensive encephalopathy. Patient due to spinal cord injury above T6 develops massive sympathomimetic surge leading to splanchnic vasoconstriction and development of HTN. This triggered reflex bradycardia. Choice D (Labetalol) is ruled out in setting of bradycardia.

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