UMEM Educational Pearls

Title: BP Control in Stroke Patients Receiving Thrombolytics

Category: Neurology

Keywords: blood pressure control, stroke, tPA, thrombolytics (PubMed Search)

Posted: 3/19/2009 by Aisha Liferidge, MD (Updated: 11/23/2024)
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A patient's blood pressure should be maintained at less than 185/110 prior to receiving thrombolytics for stroke.

The following medications should be used to address blood pressure control in these patients:

Labetalol 10 to 20 mg IV over 1 to 2 minutes, may repeat x 1

              OR

               Nitropaste 1 to 2 inches

               OR

               Nicardipine infusion at 5 mg per hour, titrate by 0.25 mg/hr at 5 to 10 minute intervals up to a maximum

dose of of 15 mg/hr. Once desired blood pressure is achieved, titrate down in increments of 3 mg/hr.