| 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:
- Antihypertensive
- Intermittent doses
|
| Administration: |
- IV Direct:
- maximum rate of injection 5 mg/min
- IV Infusion:
- 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.
|
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