vasodilator of choice in aortic dissection

[Dred Pirate]

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I was reading the last guidelines I could find (2010) - and they said that nipride is the vasodilator of choice when beta blockade alone is insufficient to lower SBP to 100-110. In practice we use nicardipine the vast majority of the time, one reason is to avoid cyanide toxicitity. Does anyone know of updated guidelines?

 

[slimcutt]

Lol

 

[Dred Pirate]

For some reason I was thinking lisinopril was what I've seen used

I left out some info - I was referring to emergency room treatment, basically when we are buying time to get the patient to the OR.

 

[wishingiwasonabeach]

I believe using nitroprusside OR nicardipine OR fenoldapam PLUS and IV B-blocker (labetalol or esmolol) are all appropriate depending on what's on formulary and such

 

[Dred Pirate]

I believe using nitroprusside OR nicardipine OR fenoldapam PLUS and IV B-blocker (labetalol or esmolol) are all appropriate depending on what's on formulary and such

I generally have used nicardipine (fenoldapam is rarely used here) if the beta blocker is not enough. (FYI - always always always use the bete blocker, even if the HR is 65!