DRUG CARD

Generic Name: hydralazine

Brand Name: Apresoline

Drug Class: Antihypertensive, Direct acting Vasodilator

Preg Category (category and meaning): Category C- Crosses the placenta and in to breastmilk

Why Prescribed: To treat moderate to severe hypertension

-To treat hypertension in eclampsia

Routes and Dosages:

Hypertension:

Adult: oral, 50mg three times a day

IV or IM, 20-40mg, repeat as necessary

Child: oral, 7.5mg/kg/d or 200mg/d

IV or IM, 0.1-0.2mg/kg/dose every 4-6 hours as needed

Hypertension in eclampsia:

Adult: IV, 5-10mg bolus every 20 minutes; after 20 minutes try a different drug

Side Effects: Many are due to increased cardiac output

palpitations, tachycardia, angina, anorexia, nausea, and vomiting  usually resolved when dose is reduced.

Serious adverse effect: development of symptoms of systemic lupus erythematosus

Contraindications: contraindicated with coronary artery disease and mitral valvular rheumatic disease.

Administered with caution to patients with advanced renal damage, cerebral vascular accidents, suspected coronary artery disease, pulmonary

hypertension, and sensitivity to tartrazine (FDA yellow dye #5).

Drug interactions: Metoprolol, propranolol, furosemide, and indomethacin

Pharmacokinetics (Absorption, Distribution, Metabolism, Excretion):

-Absorbed: orally. Peak: 1 to 2 hours. Metabolized: liver. Excreted: kidneys.

Nursing Considerations (Assessment, labs, vitals, ect..)

-Development of symptoms of systemic lupus erythematosus can affect complete blood count and antinuclear antibody titer- Monitor these lab

results to assess for adverse effects from the drug

-Assess for signs of peripheral neuritis (numbness and tingling in hands and feet): if present seek order to administer pyridoxine (B vitamin)

- hydralazine plasma renin activity leading to production of angiotension IIangiotension II aldosterone production  sodium and water

retention. Commonly administered with diuretic

- preferentially dilates arterioles rather than veins

Patient Teaching:

-Inform patient of adverse effects

-Teach patient of the signs and symptoms that they should report

Antidote if any (Include dose, route, assessment parameters):

Administer hydralazine with a beta blocker (preferably) or clonidine to decrease reflex tachycardia and with a diuretic to offset fluid retention
 References

Hydralazine (Rx)Brand and Other Names:. (n.d.). Retrieved September 20, 2015, from

http://reference.medscape.com/drug/apresoline-hydralazine-342400