What to Monitor for with hydralazine?
Hydralazine Nursing ImplicationsHydralazine Nursing Pharmacology Show
Hydralazine is a medication used to treat hypertension, under the classification of vasodilators. Its function is to relax blood vessels so the blood can flow easily through them. Although it was originally developed as a treatment for malaria in the 1950s, hydralazine manifests the ability to lower high blood pressure and it was, later, utilized for a new purpose. Indications of Hydralazine
Mechanism of Action of HydralazineHydralazine is a drug that directly dilates the arteriole, a small branch of the artery that leads to capillaries. According to research, the exact mechanism is not entirely understood, but theories state that it is connected with intracellular calcium hemostasis. Hydralazine prevents calcium metabolism and transport in the vascular smooth muscles that are responsible for the contraction. The effect of hydralazine in the peripheral vessels is it relaxes the arteriolar smooth muscle, lowering the pressure in the artery, reducing vascular resistant while improving the heart rate, stroke volume, and cardiac output that resulting in a lowering of blood pressure. Also, hydralazine improves the blood flow to the brain and kidneys. Pharmacokinetics of HydralazineHydralazine has greatly been a drug of choice in treating congestive heart failure, and hypertension, for it causes dilatation of arterioles. Its related reflex-baroreceptor moderator responses or increase heart rate and greater ejection velocity are reduced in congestive heart failure.
Data describes that Hydralazine is well absorbed in the gastrointestinal tract. If oral hydralazine is taken with food, the bioavailability of the medication is increased. Bioavailability: Slow acetylator: 30-50%; rapid acetylator: 22-30%. If given intravenously, the onset of effect is 5 to 20 minutes, with a maximum effect of 10 to 80 minutes. Meanwhile, if taken orally, it is rapidly absorbed. The blood pressure-lowering effect is effect 20 to 300 minutes. Duration: For oral dosing, the total duration is 3 to 8 hours and for intravenous dosing, the total duration is 1 to 4 hours.
Protein-bound is 85% to 90% Vd: 0.3 to 8.2 L/kg
Hydralazine is metabolized extensively by the Liver. In total, there is 5 known metabolic pathway for hydralazine. The minor metabolic pathway for hydralazine is called Acetylation, and the major pathway is called hydroxylation. It can undergo the process and metabolize to either phthalazine or α-ketoglutarate hydrazone. It can be later on converted to or directly metabolize into phthalazinone. Hydralazine may go through a changeable conversion to the active form of hydralazine acetone hydrazone. It can be converted continuously to the active pyruvic acid hydrazone or the pyruvic acid hydrazone tricyclic dehydration product. These by-products can transform to and fro between these two forms.
65% to 95% of hydralazine is excreted in the urine, and less than 10% is recovered in the feces. The half-life of hydralazine is about 2.2 to 7.8h in rapid acetylators and 2.0 to 5.8h in slow acetylators. In patients with heart failure, the half-life is 57 to 241 minutes and 105 minutes on average. For cases of patients with hypertension, the half-life is 200 minutes for rapid acetylators and 297 minutes for slow acetylators. Generally, slow acetylators have a higher level of plasma hydralazine, thus requiring a lower dose to control blood pressure. However, other components like acetylation as a minor metabolic pathway for hydralazine may put up to differences in elimination rate. Side Effects of HydralazineSome side effects can be experienced when taking hydralazine. These side effects are mild and expected to subside within a couple of days. Inform the doctor immediately if these symptoms last longer and got worsen:
The following are some serious side effects that may occur. It is recommended to call for an immediate medical response if any of these happen:
Adverse Reactions to Hydralazine
Hydralazine OverdoseThe following symptoms may be presented in patients experiencing hydralazine overdose:
If an overdose happens outside a healthcare facility, call emergency services immediately or any poison control helpline. Drug Interactions with HydralazineBefore taking hydralazine or any medication, consult first with the doctor or pharmacist if there is any drug combination that should be avoided. Drug interactions may change how effective other medications are or it may increase the risk of serious side effects. Make a list of all the medicine, including the prescription and nonprescription drugs, vitamins, and herbal supplements as well. It is important not to start, stop, or change medication, or its dosage without consulting the doctor first. Here are some products that may have interactions with hydralazine:
Other medications include:
Nursing Care Plan for Patients on HydralazinePossible Hydralizine Nursing Diagnoses
Nursing Assessment
Nursing Planning and Intervention
Nursing Evaluation
Nursing ReferencesAckley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. Buy on Amazon Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier. Buy on Amazon Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Buy on Amazon Disclaimer:Please follow your facilities guidelines, policies, and procedures. The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment. Does hydralazine affect potassium levels?This medicine may cause a loss of potassium from your body. To help prevent this, your doctor may want you to: eat or drink foods that have a high potassium content (for example, orange or other citrus fruit juices), or.
Does hydralazine affect pulse?Bottom Line. Hydralazine lowers blood pressure (BP) but also stimulates the heart which may increase the heart rate and lead to angina symptoms.
Which of the following is a side effect of hydralazine?Headache, pounding/fast heartbeat, loss of appetite, nausea, vomiting, diarrhea, or dizziness may occur as your body adjusts to the medication. If any of these effects last or get worse, tell your doctor or pharmacist promptly.
Does hydralazine affect systolic or diastolic blood pressure?Hydralazine is a direct arteriolar vasodilator, with little effect on venous capacitance vessels, that produces a rapid BP decrease with diastolic pressure reduced more than systolic.
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