Peripheral Vasodilator

Question 1

Brand name for Hydralazine?

Answer 1

Apresoline

Question 2

class?

Answer 2

peripheral vasodilator

Question 3

dosage form?

Answer 3

oral tablet

Question 4

indication?

Answer 4

HTN

Question 5

MOA?

Answer 5

vasodilator that reduces total peripheral resistance by direct action on the smooth muscle and acts more greatly on the arterioles than on veins

Question 6

contraindication?

Answer 6

Hypersensitivity to hydralazine; dissecting aortic aneurysm; coronary artery disease; mitral valve rheumatic heart disease

Question 7

Common ADR?

Answer 7

None

Question 8

Less Common?

Answer 8

Anorexia, chest pain, diarrhea, dizziness, headache, hypotension, nasal congestion, palpitations, reflex tachycardia, vomiting

Question 9

Rare but serious?

Answer 9

Agranulocytosis, hepatotoxicity, leukopenia, systemic lupus erythematosus

Question 10

Monitoring?

Answer 10

Efficacy Monitoring Parameters. Decrease in systolic and diastolic BP, improvement in signs/symptoms of heart failure.

Toxicity Monitoring Parameters. Signs/symptoms of hypotension or liver damage. CBC and antinuclear antibody titers at baseline and periodically during prolonged treatment.

Question 11

Key Patient Counselling Point?

Answer 11

Patient does not drink alcohol while taking drug; Hydralazine may cause drug-induced lupus erythematosus (DILE) and has a higher incidence compared to other drugs associated with DILE. Thiazide diuretics, calcium channel blockers, ACEIs, and ARBs are preferred. Hydralazine may be beneficial in patients intolerant of ACEIs or ARBs and when added ACEIs or ARBs in African Americans. Commonly used off-label in conjunction with nitrates in various subgroups of patients with systolic heart failure. Injectable formulation also available.