Intravenous Use of Nicardipine and Sodium Nitroprusside as Second Line Treatment in Chronic Hypertension with Superimposed Severe Preeclampsia Patient - การใช้ยา nicardipine และ sodium nitroprusside ทางหลอดเลือดดำ เป็นทางเลือกที่สองในการรักษาผู้ป่วยที่เป็น โรคความดันโลหิต ูงอยู่ก่อนการตั้งครรภ์ และมีภาวะครรภ์เป็นพิษซ้ำเติม

Abstract

               A case report of nullipara pregnant woman with chronic hypertension and has superimposed severe preeclampsia at 31 weeks of gestation.  Termination of pregnancy was performed by cesarean section.  Before delivery, magnesium sulphate was intravenous administered to prevent convulsions and oral form of nifedipine was used to control blood pressure several times, but blood pressure of the patient still remained in dangerous range.  Then intravenous nicardipine was use and could control blood pressure to be within a safety range.  In postpartum period, blood pressure of the patient periodically fell in a dangerous range.  Medicine doctor was consulted and intravenous sodium nitroprusside was administered.  It had rapid onset of action and could control blood pressure to fall back to a safety range immediately.  In conclusion, intravenous use of nicardipine and sodium nitroprusside can be used to control hypertensive crisis in pregnancy with rapid onset and effectiveness.  Both drugs can be used alternatively to hydralazine (nepresolÒ) that was commercially unavailable then.

Key words:      chronic hypertension, superimposed severe preeclampsia, nicardipine, sodium nitroprusside