Generic Name: Hydralazine

Brand Name: Apresoline

Classification: Antihypertensive, Vasodilator

Indications:

• Moderate to severe hypertension (with a diuretic). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems.
• CHF unresponsive to conventional therapy with Digoxin and diuretics

Mechanism of Action

Hydralazine is a vasodilator that works by relaxing the muscles in the blood vessels to help them dilate (widen). This lowers blood pressure and allows blood to flow more easily through the veins and arteries.

Contraindications

1. Hypersensitivity
2. Severe tachycardia
3. Dissecting aortic aneurysm
4. Heart failure with high cardiac output
5. Cor pulmonale
6. Myocardial insufficiency due to mechanical obstruction
7. Coronary artery diseas
8. Idiopathic SLE
9. Patients with recent MI

Use cautiously in:

1. Cardiovascular or  Cerebrovascular disorders: Ischemic heart disease, rheumatic heart disease affecting the mitral valve
2. Severe renal and hepatic disease
3. Pregnancy
4. Lactation
5. Children

Adverse Reactions and Side Effects:

1. Dizziness
2. Drowsiness
3. Headache
4. Tachycardia
5. Angina
6. Arrhythmias
7. Edema
8. Orthostatic hypotension
9. Diarrhea
10. Nausea and vomiting
11. Rashes
12. Sodium retention
13. Arthralgias
14. Arthritis
15. Peripheral neuropathy
16. Drug induced lupus syndrome

Nursing Responsibilities

1. Monitor the client’s blood pressure and pulse frequently during initial dosage adjustment and periodically throughout therapy. Report significant changes to the physician.
2. Monitor frequency of prescription refills to determine adherence.
3. Prior to and periodically during prolonged therapy the following lab values should be monitored: CBC, electrolytes, LE Cell Prep and ANA titer.
4. The nurse must be aware that Hydralazine may cause a positive direct Coomb’s test result.
5. IM or IV route should be used only when the drug cannot be given orally.
6. Hydralazine may be administered concurrently with diuretics or beta blockers to permit lower doses and minimize side effects.
7. Instruct the patient not to let anyone else take his or her medication.
8. Inform the patient to take hydralazine with meals or a snack.
9. Instruct the patient to take this medication exactly as prescribed by the doctor. He or she should not take it in larger amounts or for longer than recommended. Directions on the prescription label should be followed.
10. It is important to remind the patient to keep using Hydralazine as directed, even if he or she feels well. High blood blood pressure often has no symptoms, so you may not know when your blood pressure is high.
11. STORAGE: Store hydralazine at room temperature away from moisture and heat.
12. In cases where the patient missed a dose he or she should take the missed dose as soon as he or she remembers. If it is almost time for the next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.
13. Instruct the patient to call the physician immediately if he or she experiences the following symptoms:

• Fainting
• Joint or muscle pain
• Unexplained fever
• Rapid heartbeat
• Chest pain
• Swollen ankles or feet
• Numbing or tingling in hands or feet