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Action: vasodilates arteriolar smooth muscle by direct relaxation Uses: essential hypertension, hypertensive emergency/urgency UNLABLED USES: CHF,preeclamsia hydrALAZINE Apresoline Antihypertensive Dosages: Adult: 10mg qid 2-4days, then 25mg for rest of first week, then 50 mg qid individualized,max 300 qid mg/day Child: 0.75-1mg/day, increase max 7.5mg/day A: 89% protein binding D: protein binding Routes: oral M: by liver Onset: 20-30 min Peak: 1-2 hrs E: 12-14% excreted in urine Duration: 2-4 hrs Half-life: 3-7hrs Common Side Effects: headache, tremors, dizziness, anxiety, palpitations, reflex tachycardia, angina, N/V, anorexia, diarrhea, lupus like symptoms Adverse Effects: shock, hepatotoxicity, leukopenia, agranulocytosis, thrombocytopenia Contraindications: mitral valvular rheumatic heart disease, CAD, Interactions: MAIO’s, EPINEPHrine, norepinephrine, antihypertensives, alcohol, levodopa, thiazide diuretics Nursing Considerations: Assess: Cardiac, electrolytes, daily I& O and weight, edema, lung sounds, mental state: evaluate; decreased BP take with food to > bioavailability notify prescriber if: Chest pain, severe fatigue, fever, muscle or joint pain rise slowly, to prevent orthostatic hypotension
