Details About Generic Salt ::  Hydralaz

Main Medicine Class:: Antihypertensive,Vasodilator   

(high-DRAL-uh-zeen HIGH-droe-KLOR-ide)
Apresoline,  Apo-Hydralazine, Novo-Hylazin, Nu-Hydral
Class: Antihypertensive/Vasodilator

 

Drugs Class ::

 Action Directly relaxes vascular smooth muscle to cause peripheral vasodilation, decreasing arterial BP and peripheral vascular resistance.

Indications for Drugs ::

 Indications Treatment of essential hypertension (oral form). Treatment of severe essential hypertension (parenteral form). Unlabeled use(s): Reduction of overload in treatment of CHF, severe aortic insufficiency, and after valve replacement.

Drug Dose ::

 Route/Dosage

Adjust individually. ADULTS: PO Begin with 10 mg qid for 2 to 4 days; then 25 mg qid for 3 to 5 days; then 50 mg qid (maximum 300 mg/day). IV/IM 20 to 40 mg repeated prn. CHILDREN: PO 0.75 mg/kg/day in 4 divided doses initially; increase gradually over 3 to 4 wk to maximum of 7.5 mg/kg/day or 200 mg/day. IV/IM 0.1 to 0.2 mg/kg/dose q 4 to 6 hr prn.

Contraindication ::

 Contraindications Coronary artery disease; mitral valvular rheumatic heart disease.

Drug Precautions ::

 Precautions

Pregnancy: Category C. Lactation: Excreted in breast milk. Children: Safety and efficacy have not been established by controlled clinical trials, but there is experience with its use. Lupus erythematosus: Drug may produce clinical picture similar to that with systemic lupus erythematosus (eg, arthralgia, dermatoses, fever, splenomegaly), including glomerulonephritis, when > 50 mg/day is given for long periods. Symptoms usually reverse when drug is discontinued, but treatment may be required. Renal impairment: Use drug with caution in patients with advanced renal damage. Tartrazine sensitivity: Some of these products contain tartrazine, which can cause allergic-type reactions in susceptible individuals, especially those who have aspirin hypersensitivity.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CV: Palpitations; tachycardia; angina pectoris; edema. CNS: Headache; peripheral neuritis with paresthesias, numbness and tingling; dizziness; tremors; depression; disorientation; anxiety. EENT: Lacrimation; conjunctivitis. GI: Anorexia; nausea; vomiting; diarrhea; constipation. HEMA: Blood dyscrasias; decreased hemoglobin; decreased RBC; leukopenia; agranulocytosis. OTHER: Hypersensitivity (eg, rash, urticaria, pruritus, fever, chills, arthralgia, eosinophilia); systemic lupus erythematosus.

Drug Mode of Action ::  

 Action Directly relaxes vascular smooth muscle to cause peripheral vasodilation, decreasing arterial BP and peripheral vascular resistance.

Drug Interactions ::

 Interactions

Beta-blockers: May increase effect of hydralazine or effect of beta-blockers. NSAIDs: Effects of hydralazine may be decreased.

Drug Assesment ::

 Assessment/Interventions

  • Obtain complete history, including drug history and any known allergies. Note use of other medications (particularly beta-blockers and NSAIDs), coronary artery disease, mitral valvular rheumatic heart disease, renal impairment, lupus erythematosus, pregnancy, lactation.
  • Monitor BP prior to and frequently during IV administration.
  • Monitor CBC and antinuclear antibody titer.
  • Monitor for orthostatic hypotension.
  • If decreased hemoglobin or RBC, leukopenia, agranulocytosis or purpura occur, report to health care provider.
  • If symptoms of lupus erythematosus or positive antinuclear antibody titer occur, notify health care provider.
  • If hypotension occurs during therapy, caution patient to sit or lie down (with head in low position). Discontinue drug and notify health care provider.
OVERDOSAGE: SIGNS & SYMPTOMS
  Hypotension, tachycardia, headache, flushing, MI, myocardial ischemia, cardiac arrhythmias, profound shock

Drug Storage/Management ::

 Administration/Storage

  • Administer oral form of drug with food.
  • Use parenteral form immediately after drawn into syringe.
  • Parenteral solution discolors after contact with metal filter.
  • Store at room temperature.

Drug Notes ::

 Patient/Family Education

  • Instruct patient to take medication with meals to enhance absorption.
  • Caution patient to avoid abrupt discontinuation of drug to prevent sudden increase in BP.
  • Encourage patient to make lifestyle changes: Weight reduction, sodium and alcohol restriction, discontinuance of smoking, regular exercise, and behavior modification.
  • Advise patient to monitor BP and weight regularly.
  • Instruct patient to report sudden weight gain caused by fluid retention.
  • Advise patient to follow health care provider’s orders for monitoring of CBC and other laboratory values.
  • Advise patient to avoid sudden changes in position or very hot baths to avoid orthostatic hypotension.
  • Caution patient not to take otc medications without consulting health care provider.
  • Instruct patient to report these symptoms to health care provider: Prolonged tiredness, muscle or joint pain, chest pain, fever, numbness or tingling of hands or feet, rash.
  • Explain that drug may cause drowsiness and to use caution when driving or performing other tasks requiring mental alertness.

Disclaimer ::

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