title: Intravenous chlorpromazine for the emergency treatment of uncontrolled symptomatic hypertension in the pre-hospital setting: data from 500 consecutive cases.
abstract: BACKGROUND
  Chlorpromazine is a dopamine-receptor antagonist antipsychotic agent. Because of its strong alpha-blocking and sedative actions, it has also been used as emergency therapy for extreme arterial hypertension. Published reports to date have included very small numbers of patients (i.e., 5-30).
  
  
  OBJECTIVE
  To analyze data on almost 500 patients who received intravenous chlorpromazine for the emergency treatment of uncontrolled symptomatic hypertension in the pre-hospital setting.
  
  
  METHODS
  We reviewed data from 496 consecutive patients who received intravenous chlorpromazine as emergency therapy for uncontrolled symptomatic hypertension. Chlorpromazine was injected intravenously. The dose was 1 mg every 2-5 minutes until the systolic pressure was < or =140 mmHg and the diastolic pressure < or =100 mmHg with alleviation of symptoms.
  
  
  RESULTS
  The mean dose of chlorpromazine administered was 4.5 +/- 5 mg (range 1-50 mg). Only 33 patients (7%) required >10 mg. Chlorpromazine reduced systolic BP from 222.82 +/- 26.31 to 164.93 +/- 22.66 mmHg (P< 0.001) and diastolic BP from 113.5 +/-16.63 to 85.83 +/- 11.61 mmHg (P< 0.001). The sinus rate decreased from 97.9 +/- 23.5 to 92.2 +/- 19.7 beats per minute (P< 0.001). These results were achieved within the first 37 +/- 11 minutes.
  
  
  CONCLUSIONS
  Intravenous chlorpromazine is safe and effective when used as emergency treatment for uncontrolled symptomatic hypertension.
authors.affiliation: Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Sami
authors.initials: S
authors.lastname: Viskin
authors.forename: Michael
authors.initials: M
authors.lastname: Berger
authors.forename: Maya
authors.initials: M
authors.lastname: Ish-Shalom
authors.forename: Nomi
authors.initials: N
authors.lastname: Malov
authors.forename: Mira
authors.initials: M
authors.lastname: Tamari
authors.forename: Michal
authors.initials: M
authors.lastname: Golovner
authors.forename: Meyara
authors.initials: M
authors.lastname: Kehati
authors.forename: David
authors.initials: D
authors.lastname: Zeltser
authors.forename: Arie
authors.initials: A
authors.lastname: Roth
mesh_terms: D000368:Aged; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002746:Chlorpromazine / Q000008:administration & dosage / Q000627:therapeutic use*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D007275:Injections, Intravenous; D008297:Male; D012189:Retrospective Studies
chemical_list: D014150:Antipsychotic Agents; D002746:Chlorpromazine