Name: HYDRALAZINE (ApresolineR)
Classification: vasodilator - antihypertensive agent
  • reduces systemic vascular resistance by direct relaxation of vascular smooth muscle
  • reduces pulmonary vascular resistance
  • dilates renal arterioles
Dose:
  • Afterload reduction:
    • 1 mg-5 mg/hr
  • Antihypertensive
    • 5 mg-25 mg/hr (titrated to effect)
  • Intermittent doses
    • 5-40 mg IV direct
Administration:
  • IV Direct:
    • maximum rate of injection 5 mg/min 
  • IV Infusion:
    • 50 mg/500 mL NS, RL
  • hypovolemia should be corrected concurrently with therapy
  • should be weaned off
Adverse Effects:
  • tachycardias
  • arrhythmias
  • hypovolemia
  • hypotension
  • increased myocardial oxygen consumption
  • peripheral neuritis as evidenced by numbness, tremor, agitation, anxiety
  • rheumatoid syndrome---systemic lupus erythematosus like syndrome
  • risk of hemorrhage in patients with cerebral or abdominal aneurysms due to speed of blood flow
  • may worsen a pulmonary shunt
Monitoring Therapy:
  • HR, ECG
  • BP
  • CVP, PCWP
  • cardiac index
  • PVRI, SVRI
  • blood gases, Sp02
  • skin
  • joint appearance and mobility
CCTC Protocol:
  • May be administered by IV infusion by any RN.
  • May be administered IV direct by an approved nurse in the CCTC at a rate < 5mg/min.
  • May be titrated by an approved nurse in the CCTC.
  • Central line is preferred.
  • Continuous infusion must be administered via an infusion pump.
  • Should not be infused via the proximal injectate port (blue) of the Swan Ganz catheter.
  • Patient requires placement of an arterial line to monitor BP if administered as a continuous infusion.


Lynne Kelly, Pharmacist, CCTC
Brenda Morgan, Clinical Nurse Specialist, CCTC
Last Update: January 12, 2017

 

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Last Updated January 12, 2017 | © 2007, LHSC, London Ontario Canada