| Name: | HYDRALAZINE (ApresolineR) |
| Classification: | Vasodilator - antihypertensive agent - Reduces systemic vascular resistance by direct relaxation of vascular smooth muscle
- Rreduces pulmonary vascular resistance
- Dilates renal arterioles
|
| Dose: | Intermittent doses - 5-40 mg IV direct (every 3-6 hours as needed)
- Eclampsia: 5-10 mg every 20-30 minutes as needed
- Maximum dose 300-400 mg/24 hours
- Increase dosing intervals in renal failure:
- Creatinine Clearance 10-50 mL/min, increase frequency to Q8H
- Creatinine Clearance less than 10 mL/min, increase frequency to Q8-16 hours
|
| Administration: | - IV Direct:
- Maximum rate of injection 5 mg/min
- Hypovolemia should be corrected concurrently with therapy
DO NOT DILUTE IN DEXTROSE CONTAINING SOLUTIONS |
| Contraindications: | - Hypersensitivity to hydralazine or its components
- Systemic Lupus Erythematosus
- Tachycardia and heart failure with high cardiac output
- Myocardial insufficiency due to mechanical obstruction
- Acute dissecting aneurysm of the aorta, coronary artery disease, rheumatic mitral valve disease,cor pulmonale
|
| Adverse Effects: | - Tachycardias
- Arrhythmias, palpitations
- Hypovolemia
- Hypotension, orthostatic hypotension
- Edema
- Malaise, fever, headache, dizziness
- Rash
- Anorexia, nausea, vomiting, diarrhea
- Arthralgia, weakness, pyridoxine deficiency-induced peripheral neuropathy
- rheumatoid syndrome---systemic lupus erythematosus like syndrome, positive ANA, positive LE cells
- Risk of hemorrhage in patients with cerebral or abdominal aneurysms due to speed of blood flow
- May worsen a pulmonary shunt
|
| Monitoring Therapy: | - Continuous heart rate and ECG rhythm
- Blood pressure
- Skin
- Joint appearance and mobility
|
| Adult Critical Care Protocol: | - May be administered by IV infusion by a nurse in Adult Critical Care.
- May be administered IV direct by an approved nurse in the CCTC at a rate < 5mg/min.
|
