Hydralazine

Question 1

Brand Name

Answer 1

Apresoline

Question 2

Broad Category

Answer 2

Antihypertensive

Question 3

Pharmacological Class

Answer 3

Direct Acting Vasodilator

Question 4

MOA

Answer 4

Direct systemic arterial vasodilator, produces direct relaxation of small arteries and arterioles while sparing venous capacitance vessels (reduces SVR and LV afterload while leaving preload unaffected)

Proposed mechanisms
- activation of KATP channels, decreasing free intracellular calcium, and blocking calcium release from SR
- Potential increase in cGMP through induced increase in vascular NO (not confirmed)

Question 5

Indications / Clinical uses

Answer 5

HTN
Heart Failure
Eclampsia
Hypertensive Asthmatics

Question 6

Bolus Dosing

Answer 6

2.5-5 mg titrated every 20-30 mins

(2.5- 20mg really lol)

Question 7

Onset

Answer 7

15-30 mins (delayed)

Question 8

Duration

Answer 8

4-6 hours

Question 9

Concentration

Answer 9

20 mg/mL

Question 10

CV effects

Answer 10

Baroreceptor mediated Reflex
- Tachycardia
- increased Contractility
- Increased SV
- Increased Overall CO
Decreased SVR

Can aggravate angina (Contraindicated in CAD)

Question 11

CNS effects

Answer 11

Increased CBF and ICP
* inhibits CBF autoregulation

HA
Dizziness
N/V
tremors

Question 12

Other effects

Answer 12

Fluid retention
nasal congestion

Question 13

Contraindications (Absolute)

Answer 13

CAD: increases myocardial oxygen demand precipitating ischemia

Question 14

Precautions

Answer 14

Elevated ICP
Slow acetylators
- induces lupus-like syndrome with chronic, high-dose admin

Question 15

Beneficial Drug-Drug interactions?

Answer 15

BB with hydralazine (propranolol) prevents baroreceptor reflex

Question 16

Metabolism

Answer 16

Hepatic
- acetylation
- hydroxylation

Question 17

Excretion

Answer 17

Renal