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Ob-Chronic Hypertension -Is HydralazineFrom: emilio porro (sanbonav@hotmail.com)Fri Dec 28 13:45:55 2007
You can use Hydralazine as I learned while attending two British Council Courses on Obstetrics in London (G.B.)at St.George Hospital from a great Obstetrician Prof. Geoffrey Chamberlain as You can see below. Yours faithfully Emilio Porro ObGyn M.D. Como-Italy http://www.bmj.com/cgi/content/full/319/7219/1270/a http://www.bmj.com/cgi/content/full/318/7193/1260 http://www.bmj.com/cgi/eletters/318/7193/1260 from wikipedia: Hydralazine Hydralazine Systematic (IUPAC) name phthalazin-1-yl hydrazine Identifiers CAS number 86-54-4 ATC code C02DB02 PubChem 3637 Chemical data Formula C8H8N4 Mol. mass 160.176 g/mol Hydralazine hydrochloride (1-hydrazinophthalazine monohydrochloride; Apresoline) is a direct-acting smooth muscle relaxant used to treat hypertension by acting as a vasodilator primarily in arteries and arterioles. By relaxing vascular smooth muscle, vasodilators act to decrease peripheral resistance, thereby lowering blood pressure.[1] Contents [hide] • 1 Mechanism • 2 Clinical Use • 3 Side effects • 4 References Mechanism Hydralazine works through a cGMP-mediated mechanism, resulting in smooth muscle relaxation.[2] Clinical Use Hydralazine is not used as a primary drug for treating hypertension because it elicits a reflex sympathetic stimulation of the heart (the baroreceptor reflex). The sympathetic stimulation may increase heart rate and cardiac output, and may cause angina pectoris or myocardial infarction.[1] Hydralazine may also increase plasma renin concentration, resulting in fluid retention. In order to prevent these undesirable side effects, hydralazine is generally prescribed in combination with a beta-blocker (e.g., propranolol) and a diuretic.[1] Hydralazine is used to treat severe hypertension, but again, it is not a first line therapy for essential hypertension. However, hydralazine is the first line therapy for hypertension in pregnancy, with methyldopa.[2] Side effects Common side effects include: • Diarrhea • Compensatory tachycardia due to baroreceptor reflex • Headache • Loss of appetite • Nausea or vomiting • Pounding heartbeat • Drug-Induced Lupus Erythematosus Patients given hydralazine over a peroid of six months may develop a lupus-like syndrome or other immune related diseases that generally are reversible with withdrawal.[1] Hydralazine is differentially acetylated by fast and slow acetylator phenotypes thus incidence of lupus-like disease in slow acetylators. References 1.a b c d Harvey, Richard A., Pamela A. Harvey, and Mark J. Mycek. Lippincott's Illustrated Reviews: Pharmacology. 2nd ed. Philadelphia: Lipincott, Williams & Wilkins, 2000. 190. 2.a b Bhushan, Vikas, Tao T. Lee, and Ali Ozturk. First Aid for the USMLE Step 1. New York: McGraw-Hill Medical, 2007. 251.
-- Emilio Porro M.D. Ob.Gyn. Como Italy http://www.sanbonaventura.com who,whose, with,what,why,where,when,while,watch world wide web
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