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Medication	Selected Adverse Effects*	Special Indications
ClevidipineClevidipine	Atrial fibrillation, fever, insomnia, nausea, headache	Most hypertensive emergencies Should be used cautiously in patients with acute heart failure
Enalaprilat	Precipitous fall in blood pressure in high-renin states, variable response	Acute left ventricular failure Should be avoided in acute myocardial infarction
EsmololEsmolol	Hypotension, nausea	Aortic dissection perioperatively
FenoldopamFenoldopam	Tachycardia, headache, nausea, flushing, hypokalemia, elevation of intraocular pressure in patients with glaucoma	Most hypertensive emergencies Should be used cautiously in patients with myocardial ischemia
HydralazineHydralazine	Tachycardia, flushing, headache, vomiting, aggravation of angina	Eclampsia
LabetalolLabetalol	Vomiting, scalp tingling, burning in throat, dizziness, nausea, heart block, orthostatic hypotension	Most hypertensive emergencies, except acute left ventricular failure Should be avoided in patients with asthma
NicardipineNicardipine	Tachycardia, headache, flushing, local phlebitis	Most hypertensive emergencies, except acute heart failure Should be used cautiously in patients with myocardial ischemia
NitroglycerinNitroglycerin	Headache, tachycardia, nausea, vomiting, apprehension, restlessness, muscular twitching, palpitations, methemoglobinemia, tolerance with prolonged use	Myocardial ischemia, heart failure
NitroprussideNitroprusside	Nausea, vomiting, agitation, muscle twitching, sweating, cutis anserina (if blood pressure is reduced too rapidly), thiocyanate and cyanide toxicity	Most hypertensive emergencies Should be used cautiously in patients with high intracranial pressure or azotemia
PhentolaminePhentolamine	Tachycardia, flushing, headache	Rarely used unless patient has a confirmed diagnosis of pheochromocytoma
* Hypotension may occur with all medications.
† A special delivery system (eg, infusion pump for nitroprusside, nonpolyvinyl chloride tubing for nitroglycerin) is required.† A special delivery system (eg, infusion pump for nitroprusside, nonpolyvinyl chloride tubing for nitroglycerin) is required.