Question about Nipride

Anyone? Where are the night nurses?

i guess it would depend on where they wanted the bp and why.

if the goal was 110-130, then i probably would have turned it down at the low pressure, i just wouldn't have gone down very much. nipride is pretty powerful.

the more i sit here and think about it, it really does depend on the whole picture. in my mind, titrating anti-hypertensives is more difficult that titrating pressors. when you are trying to increase a bp, and you are shooting for a map of 70, nothing bad is going to happen if the patient is at a map of 80 for a while.

on the other hand, when you are trying to decrease a bp, you need to make sure you maintain a pressure high enough to keep everything perfusing adequately, and you need to make sure you don't bring the pressure down too fast.

right now, there is a patient in my hospital that is in arf, most likely because his bp was transiently low in surgery (and an elective procedure at that).

in general, though, unless the pt has an aortic injury or something like that, you don't see antihypertensives to keep bp that low. (and nipride usually isn't used for aortic injuries since it doesn't help control rate). the post-op vascular surgery patients i'm used to having on nipride usually come with a goal bp of

our nipride protocol is q5min bps as well, which is the cheif reason why i hate it.

Pt came in with SBP 200. Order is to titrate to keep SBP

well, if you think that he "lives" at a sbp of 200 at home, or at least has for a while, then an sbp in the 90s isn't going to perfuse much.

if he is in acute renal failure, then it really isn't going to help get his kidneys perfused enough to recover.

i probaby would have rechecked the bp sooner than 5min, and then turned it down if it was still

ok- thanks

I would have retaken it immediately to confirm it really is 92 and titrated accordingly...I wouldn't have waited the 5 minutes.

Nipride is POTENT and requires close attention.

I would have retaken it immediately to confirm it really is 92 and titrated accordingly...I wouldn't have waited the 5 minutes.

Nipride is POTENT and requires close attention.

Agreed. It probably would have been nice to have an arterial line too.

You should have gotten a range from the MD who started the gtt, along with an art line. Nipride is a very potent antihypertensive. But in your situation, I would have immediately recycled the BP and titrated accordingly.