7 Some organizations will allow medication compounding in a specific area of practice.
Medications should be diluted or compounded in the pharmacy before dispensing and only when recommended by the manufacturer and approved by the organization’s practice. Antihypertensive therapy should not decrease arterial pressure too significantly or too rapidly because uteroplacental perfusion may be compromised, 4 resulting in an interruption of fetal oxygenation with Categorycategory II (indeterminate) or Categorycategory III (abnormal) FHR characteristics. The patient’s response to antihypertensive medication should be monitored closely if preeclampsia or eclampsia are present because eclampsia causes contracted intravascular volume. Nurses should closely and frequently monitor maternal vital signs and the fetal heart rate (FHR) pattern after hydralazine administration because of the potential for hypotension. 2, 10 Other adverse reactions include dizziness, diarrhea, nausea, vomiting, edema, and peripheral neuropathy.
1Ĭommon adverse reactions to hydralazine are headache, palpitations, tachycardia, and drug-induced lupus syndrome. The recommended initial dosage of hydralazine is 5 mg IV or IM, followed by 5 to 10 mg IV every 20 to 40 minutes to a maximum total dose of 20 mg or a constant infusion of 0.5 to 10 mg per hour. 2 Caution should be used when administering hydralazine to patients with severe renal impairment. Hydralazine is indicated for IV administration during hospitalization for severely elevated BP and is contraindicated in patients with documented hypersensitivity, coronary artery disease, or mitral valve rheumatic heart disease. 1 The drug crosses the placenta in a clinically insignificant degree. 9 Hydralazine is one of three medications available for first-line management of acute-onset severe hypertension in pregnant and postpartum women.
Increases in heart rate, stroke volume, cardiac output, and left ventricular ejection fraction typically occur with hydralazine use. Hydralazine is a peripheral vasodilator that relaxes the arteriolar smooth muscle. Take steps to eliminate interruptions and distractions during medication preparation. A precipitous decrease in maternal blood pressure (BP) may lead to shock and placental abruption, which may be life-threatening to the patient and fetus. Hydralazine (Maternal-Newborn) - CE ALERTĪntihypertensives administered with magnesium sulfate increase the risk of hypotension.
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