Hydralazine

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Tarang Patel
DNP-NA,RN,CCRN, RPh
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Included In This Lesson

Study Tools For Hydralazine

Common Antihypertensives Cheatsheet (Cheatsheet)
Drug Classes by Body System (Cheatsheet)
140 Must Know Meds (Book)
Hydralazine (Apresoline) (Picmonic)
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Outline

Overview

  1. Hydralazine- direct acting vasodilator
    1. Indications
      1. Hypertension
      2. Heart failure
    2. Mechanism of action
      1. Unclear
      2. 3 types of mechanism suggested
        1. Releases nitric oxide from vascular endothelial cells causing vasodilation
        2. Blocks the entry of calcium in the smooth muscle cells and causing vasodilation.
        3. Opening the potassium channels causing the hyperpolarization and causing the vasodilation

General

  1. Hydralazine is often given in hospital to quickly lower blood pressure
  2. Often given with a diuretic for best effect

Assessment

  1. Assessing for side effects
    1. Headache
    2. Dizziness
    3. Flushing
    4. Tachycardia and palpiations
    5. Edema

Therapeutic Management

  1. Monitor blood pressure frequently at the start of therapy
  2. Discontinue slowly to avoid rapid rise in blood pressure

Nursing Concepts

  1. Perfusion
    1. Hydralazine affects perfusion by decreasing the work load of the heart.
  2. Pharmacology
    1. Hydralazine is often prescribed to treat hypertension.

Patient Education

  1. Caution patients to avoid sudden changes in position to prevent orthostatic hypotension.
  2. Patients should weigh themselves and monitor for fluid retention.

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Transcript

So, in this one, we gonna talk about the hydralazine. This medication doesn’t fall in any category because its mechanism of actions is really unknown. There are many mechanisms are suggested and nothing’s really established with this medication. So, we can say this medication is direct-acting vasodilator. So, that’s just like its own drug, no category.

Let’s talk about the mechanism of action. It is not clear at all. So, here, you can see, there are like 3 types of mechanism suggested that this medication may be working by, but nothing specific. The first one is by releasing nitric oxide from vascular endothelial cells and causing vasodilation. Same as nitroglycerin and sodium nitroprusside like nitro compounds. Or, maybe, by blocking the entry of calcium in the smooth muscle cells and causing vasodilation, same as calcium-channel blocker. And this is not specific, they’re thinking it may be working by that or both. Or, it maybe opening the potassium channels and causing the hyperpolarization and causing the vasodilation. So, these 3 mechanism of action are not, they think the medication maybe working by this mechanism but nothing specific. This mechanism, depending on the mechanism, causes the vasodilation.

This medication maybe used for hypertension, and heart failure. The reason we use this medication for the heart failure, because when we decrease the blood pressure, it’s basically decreasing the afterload. So, when heart left ventricle pumps up the blood into the aorta. If it is decreased blood pressure, that means if aorta and all the arteries are dilated, the left ventricle doesn’t have to push hard or pump hard in order to eject the blood out of the heart into the systemic circulation. So, that’s why it decreases the work load of the heart by decreasing the blood pressure and that’s why it can be used in heart failure as well. But the main reason or the main use for this medication have seen quite often in hospitals or if a patient has high blood pressure.

What are the side effects? This medication works by dilating the vessels, it causes the headache, because when you have dilated vessels in the brain, it holds more blood, it causes the pressure on the brain cells, it causes the headache. So, like, the way it works. It causes the flushing, tachycardia, and lupus like syndrome. And this is the main one, not really often, but sometime they may ask this Hydralizine causes side effects, so, Lupus like syndrome, it can cause.

So, this is really a short drug and this doesn’t fall in any category, so, I just want to cover it separately, mainly used for the hypertension. If you have any question about this drug, feel free to ask us questions. Thanks for watching.

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Kims

Concepts Covered:

  • Cardiovascular
  • Circulatory System
  • Gastrointestinal
  • Renal
  • Respiratory Disorders
  • Cardiac Disorders
  • Acute & Chronic Renal Disorders
  • Disorders of the Adrenal Gland
  • Disorders of the Thyroid & Parathyroid Glands
  • Labor Complications
  • Substance Abuse Disorders
  • Oncology Disorders
  • Central Nervous System Disorders – Brain
  • Hematologic Disorders
  • Emergency Care of the Cardiac Patient
  • Studying
  • Urinary System
  • Pregnancy Risks
  • Cardiovascular Disorders
  • Shock
  • Shock
  • Noninfectious Respiratory Disorder
  • Liver & Gallbladder Disorders
  • Renal Disorders
  • Basics of NCLEX
  • Endocrine and Metabolic Disorders
  • Medication Administration
  • Vascular Disorders
  • Disorders of Thermoregulation
  • Disorders of Pancreas
  • Eating Disorders
  • Concepts of Population Health
  • Factors Influencing Community Health
  • Respiratory Emergencies
  • Sexually Transmitted Infections
  • Immunological Disorders
  • Integumentary Disorders
  • Peripheral Nervous System Disorders
  • Gastrointestinal Disorders
  • Upper GI Disorders
  • Infectious Respiratory Disorder
  • Musculoskeletal Disorders
  • Developmental Considerations
  • Trauma-Stress Disorders
  • Pediatric
  • Note Taking
  • Neurological Emergencies

Study Plan Lessons

02.03 Swan-Ganz Catheters for CCRN Review
02.04 Pulmonary Artery Wedge Pressure (PAWP) for CCRN Review
06.01 Organ Failure, Dysfunction & Trauma for CCRN Review
09.01 Acute Renal Failure Overview for CCRN Review
09.02 Acute Tubular Necrosis for CCRN Review
09.05 Chronic Renal Failure for CCRN Review
ABGs Nursing Normal Lab Values
ACE (angiotensin-converting enzyme) Inhibitors
Acute Coronary Syndromes (MI-ST and Non ST, Unstable Angina) for Progressive Care Certified Nurse (PCCN)
Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)
Acute Kidney Injury Case Study (60 min)
Adrenal and Thyroid Disorder Emergencies for Certified Emergency Nursing (CEN)
Adult Vital Signs (VS)
Albumin Lab Values
Alkaline Phosphatase (ALK PHOS) Lab Values
Amitriptyline (Elavil) Nursing Considerations
Anemia for Progressive Care Certified Nurse (PCCN)
Angiotensin Receptor Blockers
Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)
AV Blocks Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Backwards and Forwards
Blood Urea Nitrogen (BUN) Lab Values
Brain Natriuretic Peptide (BNP) Lab Values
Calcium and Magnesium Imbalance for Certified Emergency Nursing (CEN)
Cardiac (Heart) Disease in Pregnancy
Cardiac Course Introduction
Cardiac Glycosides
Cardiac Surgery (Post-ICU Care) for Progressive Care Certified Nurse (PCCN)
Cardiogenic Shock and Obstructive Shock for Certified Emergency Nursing (CEN)
Cardiogenic Shock For PCCN for Progressive Care Certified Nurse (PCCN)
Cardiomyopathies (Dilated, Hypertrophic, Restrictive) for Progressive Care Certified Nurse (PCCN)
Cardiopulmonary Arrest for Certified Emergency Nursing (CEN)
Causes of Dyspnea Nursing Mnemonic (The 6 P’s)
Chronic Kidney Disease (CKD) Case Study (45 min)
Cirrhosis Case Study (45 min)
Congenital Heart Defects (CHD)
Congestive Heart Failure (CHF) Labs
Congestive Heart Failure Concept Map
COPD Exacerbation for Progressive Care Certified Nurse (PCCN)
Coumarins
Creatinine (Cr) Lab Values
Creatinine Clearance Lab Values
Critical Thinking
Defects of Decreased Pulmonary Blood Flow
Defects of Increased Pulmonary Blood Flow
Disease Specific Medications
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Dobutamine (Dobutrex) Nursing Considerations
Dysrhythmias for Certified Emergency Nursing (CEN)
Dysrhythmias Labs
Endocarditis for Certified Emergency Nursing (CEN)
Erythrocyte Sedimentation Rate (ESR) Lab Values
Fluid Volume Deficit
Fluid Volume Overload
Heart (Cardiac) and Great Vessels Assessment
Heart (Cardiac) Failure Module Intro
Heart (Cardiac) Failure Therapeutic Management
Heart (Cardiac) Sound Locations and Auscultation
Heart (Heart) Failure Exacerbation
Heart Failure – Live Tutoring Archive
Heart Failure – Right Sided Nursing Mnemonic (HEAD)
Heart Failure (Acute Exacerbations, Chronic) for Progressive Care Certified Nurse (PCCN)
Heart Failure 2 – Live Tutoring Archive
Heart Failure Case Study (45 min)
Heart Failure for Certified Emergency Nursing (CEN)
Heart Failure-Left-Sided Nursing Mnemonic (CHOP)
Heart Failure-Origin Nursing Mnemonic (Left – Lung|Right – Rest)
Hepatic Disorders (Cirrhosis, Hepatitis, Portal Hypertension) for Progressive Care Certified Nurse (PCCN)
Hydralazine
Hyperkalemia – Causes Nursing Mnemonic (MACHINE)
Hypertension (Uncontrolled) and Hypertensive Crisis for Progressive Care Certified Nurse (PCCN)
Hypertension- Complications Nursing Mnemonic (The 4 C’s)
Hypertensive Emergency
Hyperthermia (Thermoregulation)
Hypertonic Solutions (IV solutions)
Hypoglycemia for Progressive Care Certified Nurse (PCCN)
Isotonic Solutions (IV solutions)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Malnutrition (Failure to Thrive, Malabsorption Disorders) for Progressive Care Certified Nurse (PCCN)
Metoprolol (Toprol XL) Nursing Considerations
Minimally-Invasive Cardiac Surgery (Non-Sternal Approach) for Progressive Care Certified Nurse (PCCN)
Mixed (Cardiac) Heart Defects
Myocardial Infarction (MI) Case Study (45 min)
Nitro Compounds
Nitroglycerin (Nitrostat) Nursing Considerations
NSAIDs
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Pulmonary Edema
Nursing Care and Pathophysiology for Pulmonary Embolism
Nursing Care and Pathophysiology for Rhabdomyolysis
Nursing Care and Pathophysiology for SIRS & MODS
Nursing Care and Pathophysiology for Syphilis (STI)
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care Plan (NCP) for Abruptio Placentae / Placental abruption
Nursing Care Plan (NCP) for Activity Intolerance
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Acute Respiratory Distress Syndrome
Nursing Care Plan (NCP) for Anaphylaxis
Nursing Care Plan (NCP) for Angina
Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)
Nursing Care Plan (NCP) for Blunt Chest Trauma
Nursing Care Plan (NCP) for Bronchiolitis / Respiratory Syncytial Virus (RSV)
Nursing Care Plan (NCP) for Burn Injury (First, Second, Third degree)
Nursing Care Plan (NCP) for Cardiogenic Shock
Nursing Care Plan (NCP) for Cardiomyopathy
Nursing Care Plan (NCP) for Chronic Kidney Disease
Nursing Care Plan (NCP) for Chronic Obstructive Pulmonary Disease (COPD)
Nursing Care Plan (NCP) for Congenital Heart Defects
Nursing Care Plan (NCP) for Congestive Heart Failure (CHF)
Nursing Care Plan (NCP) for Decreased Cardiac Output
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Disseminated Intravascular Coagulation (DIC)
Nursing Care Plan (NCP) for Ectopic Pregnancy
Nursing Care Plan (NCP) for Encephalopathy
Nursing Care Plan (NCP) for Endocarditis
Nursing Care Plan (NCP) for Epiglottitis
Nursing Care Plan (NCP) for Guillain-Barre
Nursing Care Plan (NCP) for Heart Valve Disorders
Nursing Care Plan (NCP) for Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
Nursing Care Plan (NCP) for Hypertension (HTN)
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Impaired Gas Exchange
Nursing Care Plan (NCP) for Imperforate Anus
Nursing Care Plan (NCP) for Myocardial Infarction (MI)
Nursing Care Plan (NCP) for Omphalocele
Nursing Care Plan (NCP) for Pancreatitis
Nursing Care Plan (NCP) for Pericarditis
Nursing Care Plan (NCP) for Pneumonia
Nursing Care Plan (NCP) for Pulmonary Embolism
Nursing Care Plan (NCP) for Respiratory Failure
Nursing Care Plan (NCP) for Rheumatic Fever
Nursing Care Plan (NCP) for Risk for Fall
Nursing Care Plan (NCP) for Sepsis
Nursing Care Plan (NCP) for Syncope (Fainting)
Nursing Care Plan (NCP) for Systemic Lupus Erythematosus (SLE)
Nursing Care Plan (NCP) for Thoracentesis (Procedure)
Nursing Care Plan (NCP) for Thrombophlebitis / Deep Vein Thrombosis (DVT)
Nursing Care Plan for Coronary Artery Disease (CAD)
Nursing Care Plan for Distributive Shock
Nursing Care Plan for Myocarditis
Nursing Care Plan for Pulmonary Edema
Nursing Case Study for Acute Kidney Injury
Nursing Case Study for Cardiogenic Shock
Nutrition (Diet) in Disease
Obstructive Heart (Cardiac) Defects
Palliative Care for Progressive Care Certified Nurse (PCCN)
Pediatric Advanced Life Support (PALS)
Peritoneal Dialysis (PD)
Pleural Effusion for Certified Emergency Nursing (CEN)
Pleural Space Complications (Pneumothorax, Hemothorax, Pleural Effusion, Empyema, Chylothorax) for Progressive Care Certified Nurse (PCCN)
Potassium-K (Hyperkalemia, Hypokalemia)
Preeclampsia, Eclampsia, and HELLP Syndrome for Certified Emergency Nursing (CEN)
Preload and Afterload
Pulmonary Hypertension for Certified Emergency Nursing (CEN)
Renin Angiotensin Aldosterone System (RAAS)
Resources for Lesson Creation
Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Rheumatic Fever
Shock States (Anaphylactic, Hypovolemic) For PCCN for Progressive Care Certified Nurse (PCCN)
Sodium and Potassium Imbalance for Certified Emergency Nursing (CEN)
Specialty Diets (Nutrition)
Start and End with the Linchpin
Stroke Concept Map
Sympatholytics (Alpha & Beta Blockers)
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Tenet 2 Linchpins & Connections