Hydralazine


Hydralazine/Apresoline

Classifications: Vasodilator

Action: smooth muscle relaxant, indicated for severe hypertension unresponsive to other therapy.

Adverse reactions:

 CNS: peripheral neuritis, headache, dizziness

    CV: orthostatic hypotension, tachycardia, oedema, angina, palpitations, chest pain.

     GI: nausea, vomiting, diarrhoea, anorexia, constipation

     Haematologic: neutropenia, leucopenia, agranulocytopenia

     Skin:rash, flushing, sweating

Contraindications: hypersensitivity, CAD, dissecting aortic aneurysm,mitral valve rheumatic Heart disease

Care considerations: use cautiously in elderly adults or those with HF, CVA, impaired hepatic or renal function or those taking other hypertensives.

Monitor BP, pulse rate and weight frequently. Can be combined with diuretics and beta blockers to decrease sodium retention and tachycardia to prevent anginal attacks.

Monitor every 5 mins if given IV.

Monitor fetal heart rate if pregnant.

Elderly may be more sensitive to hypotensive effects.

Monitor FBE, lupus

Alert:Check person for signs of lupus like syndrome(sore throat, fever, muscle and joint aches and rash).  Administer b i d to improve compliance

May cause positive antinuclear antibody titre; pos lupu erythematous cell preps, blood dyscrasias, (leucopenia, agranulocytosis, pupura, low HB and rbc counts.

Dose:   25 mg PO bid

Drug-drug: Ace inhibitors, calcium agonists, diazoxide, diretics, major tranquillisers, MAOinhibitors, trycyclic antideprssants.

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