18.有關治療高血壓急症（hypertensive urgency），下列敘述何者錯誤？
(A)為了防止出血性中風，應該以靜脈注射降壓藥，將血壓迅速降至正常值
(B)最好在目前使用的口服降壓藥之外，另加入新的降壓藥；或增加原來用藥之劑量
(C)不可使用immediate-release的nifedipine口服或舌下給藥，因為可能引起心肌梗塞
(D)最好使用口服降壓藥讓病人在幾小時到幾天內，將血壓降低到第一階段（stage 1）血壓值

emergency會器官受損，要趕快降壓，用iv

urgency不會器損，在幾天內慢慢降壓就好，po即可

(C)選項

30.下列何種藥品不建議用來治療hypertensive urgency？ 

(A)Immediate-release nifedipine 
(B)Clonidine 
(C)Labetalol 
(D)Captopril 

高血壓急症定義 : 出現高血壓，但未危及生命或出現器官衰竭，通常是本身有在吃講血壓藥品，忘記服用或是吃太鹹導致

(A)不太會用靜脈的降血壓藥品，用口服即可，而且血壓也應在數小時，一般是4小時，降原本高血壓的25%，不可降太快

SBP > 120 mm hg

Severe hypertension (usually a diastolic blood pressure above 120 mmHg) with evidence of acute end-organ damage is defined as a hypertensive emergency.  Hypertensive emergencies can be life-threatening and require immediate treatment, usually with parenteral medications in a monitored setting

Severe hypertension (usually a diastolic blood pressure above 120 mmHg) in asymptomatic patients who are not experiencing acute end-organ damage is referred to as hypertensive urgency. There is no proven benefit from rapid reduction in blood pressure in such patients. Hypertensive urgency is common in clinical practice, especially among patients with known hypertension who are not fully adherent to their medications. Most cases of asymptomatic blood pressure elevations can be addressed in the office setting without referral to a higher level of care.

https://www.uptodate.com/contents/overview-of-hypertension-in-adults