Intravenous Antihypertensive Drugs Commonly Used in the Perioperative Setting

DRUG Mechanism DOSE Bolus Infusion Onset DURATION Plasma Half-Life Clinical Effecta Metoprolol 1-5 mg 1-5 min Half-life: 3-7 h 1 Blocker Clinical: 1-4 h Labetalol 5-20 mg 1-5 min Half-life: 6 h 1, 1, 2 Blocker 0.5-2 mg/min Clinical: 1-4 h Esmolol 50-300 μg/kg/min 1-2 min Half-life: 9 min 1 Blocker Nicardipine 100 μg 2-10 min Half-life: 2-4 h Dihydropyridine Ca blocker 5-15 mg/h Clinical: 30-60 min Hydralazine 5-20 mg 5-20 min Half-life: 2-8 h Arteriolar dilator Clinical: 1-8 h Fenoldopam 0.05-1.6 μg/kg/min 5-10 min Half-life: 5 min Dopamine type 1 agonist Clinical: 30-60 min Nitroprusside 0.25-4 μg/kg/min 1-2 min Half-life: <10 min NO donor Clinical: 1-10 min Nitroglycerin 5-300 μg/kg/min 1-2 min Half-life: 1-3 min NO donor Clinical: 5-10 min

^aClinical effect commonly seen after bolus dose or stopping infusion.