Cardiac: Antihypertensives- ACE Inhibitors

Question 1

Hydralazine (Apresoline)

Onset: 5-15 minutes
Peak effects: less than 80 minutes
Duration: 2-6 hours
Half-life: 2-8 hours

MOA: Hydralazine relaxes vascular smooth muscle, primarily in the arterial system, causing decreased arterial pressure (diastolic greater than systolic), decreased peripheral vascular resistance, and increased cardiac output.

Answer 1

Class: antihypertensive and vasodilator

Description: a potent vasodilating agent used to lower BP in cases of hypertensive crisis

Indications: used in hypertensive emergencies, and HTN complicating pregnancy (pre-eclampsia and eclampsia)

Contraindications: known hypersensitivity, CAD, or rheumatic heart disease involving the mitral valve

Precautions: May cause angina pectoris or ECG changes, due to increased cardiac output. Should not be used in children. Headache, nausea, and vomiting will more than likely occur.

Side effects: headache, dizziness, AMS, tachycardia, arrhythmias, orthostasis, chest pain, N/V

Interactions: effects can be potentiated when administered with other antihypertensive agents

Route: IM, IV

Dosage: 10-20 mg (for IV); 10-40 mg (for IM)

Question 2

. Enalaprilat (Vasotec)
. Captopril (Capoten)
. Sodium Nitroprusside (Nitropress, Nipride)