Blood pressure 160 mm Hg systolic and/or 105 mm Hg diastolic if sustained
	Hydralazine (Apresazide): Start with 5 mg IV or 10 mg IM; if blood pressure is not controlled,* repeat at 20-minute intervals (with 5 to 10 mg, depending on response). Once blood pressure control is achieved, repeat as needed (usually about every three hours). If no success by 20 mg IV or 30 mg IM total, consider another drug.
	Labetalol (Normodyne): Start with 20 mg IV bolus; if effect is suboptimal, give 40 mg 10 minutes later and 80 mg every 10 minutes for two additional doses. Use a maximum of 220 mg. If desired blood pressure levels* are not achieved, switch to another drug. Avoid using labetalol in women with asthma or congestive heart failure.
	Nifedipine (Procardia)*: Start with 10 mg orally and repeat in 30 minutes if necessary. (Short-acting nifedipine is not approved by the FDA for management of hypertension.)
	Nitroprusside (Nipride) is rarely needed for treatment of hypertension not responding to the drugs listed above or if there are clinical findings of hypertensive encephalopathy. Start at a rate of 0.25 mg per kg per minute to a maximal dose of 5 mg per kg per minute. Fetal cyanide poisoning may occur if used for more than four hours.