- 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