The Hip: Preservation, Replacement and Revision

Hydralazine/Apresoline


- For mod - to severe HTN & CHF; 
- Hydralazine can be used to effect transition from continuous infusion agents to bolous agents which in effects gets pt off "drip" (Nitroprusside) - Adult Dosing: 
- begin w/ 10mg PO qid for 2-4 days, then incr to 25mg qid, may incr to 50mg qid after 2 weeks, titrate to effect, 
- for rapid control of pressure: 10-40mg IV q 4-6 hrs; 
- use w/ caution; start w/ low doses; 
- Max of 300mg/day; 
- Precautions: 
- doses > 300 mg may cause syndrome similar to LUPUS;

- must monitor Blood Pressure frequently, maximal hypotensive effect occurs within 20-80min; 
- Reflex Sympathetic Tachycardia is treated with Propanolol
- Use lower doses in Renal failure; 
- if Tachycardia is seen during the hydralazine treatment, one may add Beta blocker (esp. Propanolol); 
- Peds: Hypertensive crisis
- 0.1-0.2 mg/kg/dose IM or IV q4-6 hr prn; 
- Chronic HTN: 0.75-3.0 mg/kg/24hr PO divided q6-12 hr




Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, December 16, 2011 3:11 pm