Which medications are used to treat acute ischemic stroke associated with a hypertensive emergency?

Updated: Feb 05, 2018
  • Author: Christy Hopkins, MD, MPH; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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For acute ischemic stroke, the preferred medications are labetalol and nicardipine. Withhold antihypertensive medications unless the SBP is above 220 mm Hg or the DBP is over 120 mm Hg, UNLESS the patient is eligible for IV tissue plasminogen activator (tPA); then, the goal is a gradual reduction of BP with a goal SBP of less than 185 mm Hg and a DBP below 110 mm Hg before initiating thrombolitic therapy. [21] After initiating drug therapy but before administering tPA, the SBP should be maintained at less than 180 mm Hg and the DBP below 105 mm Hg for 24 hours. [21, 26]

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