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options include metoprolol 5 mg iv up to 4 doses 15 min apart, esmolol 50 to 200 mcg kg min in a constant iv infusion, and labetalol an alpha- and beta-adrenergic blocker 1 to 2 mg min in a constant iv Purchase infusion or 5 to 20 mg iv initial bolus with additional doses of 20 to 40 mg given q 10 to 20 min until bp is controlled or a total of 300 mg has been given, followed by additional 20- to 40-mg doses q 4 to 8 h prn.

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