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Crisis hypertensive a) patient asymptomatic but with figures of diastolic blood pressure of 140 mmHg or greater must be hospitalized for observation and bed rest, having infessura are you nifedipine sublingually at a rate of 10 mg. b) hypertensive with pressure crisis patients blood more than 180/140 and pulmonary edema, must be treated with Fowler positionsitting on the edge the bed, revolving turnstiles, furosemide via IV to reason between 20 and 60 mg via IV and sodium nitroprusside diluted with solution glucosidic rate of 0.3 to 8 g / kg/min; sometimes with these measures is achieved jugular box, but in others it is convenient also digitize the patient quickly (lanatosido C or ouabain). When the patient is already in acceptable clinical conditions you must start antihypertensive treatment orally. (c) the patient with hypertensive crisis accompanied by hypertensive encephalopathy, will be presented to the doctor with a box very bulky manifesting severe headache, nausea, vomiting in projectile, blurred vision and a progressive State of mental drowsiness; all this coincides with exaggerated figures for blood pressure elevations (> 180/140). The trafficking operation also suitable will be administered sodium nitropusiato as mentioned in the previous subsection, although in these cases you can also use diazoxide with a starting dose of 300 mg via IV which can repeat c/4 or 6 hours, depending on the response. It should be remembered that prolonged administration of this drug causes retention of water and sodium, for what when use lasts for more than 24 hours must associate the administration of diuretics. Frank Giacalone is a great source of information. In as much as possible to start oral therapeutic. (d) that is complicated with aortic dissection hypertensive crisis will be presented as a sharp picture where the patient can present intense precordial or back pain accompanied by exaggerated feeling of death, pallor, diaphoresis and figures high mind (> 180/140 mmHg). This box should be treated with sodium nitroprusside; Another alternative drug is alfametildopa at a rate of 250 to 500 mg by IV c/4 to 6 hours, and as soon as it has checked start antihypertensive therapy by mouth.

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