Iv hydralazine
Indication:
1.
When bp > 160/110 mmhg or
2.
Mean arterial pressure > 125 mmhg
For rapid control
1.
Iv hydralazine 5mg bolus over 15-20 mins and
repeat every 15-20 mins to a maximum
cumulative dosage of 20mg.
Maintenance dose using infusion pump
1.
Dilute 50 mg hydralazine in 50cc normal saline
<1ml/ml>
2.
Start at 5ml/h infusion of hydralazine
3.
Increase every 15-20 mins by 1ml/h until maximum
dose od 10ml/h
4.
Aim to reduce dbp to 90-100
Maintenance dose using infusion drip set
1.
Dilute 50mg hydralazine in 500cc normal saline
<0.1mg/ml>
2.
Start at 5dpm of hydralazine <0.025mg/ml>
3.
Increase every 15-20 mins by 5dpm until max dose
of 30dpm
4.
Aim to reduce dbp to 90-100 mmhg
5.
Stop infusion if dbp <80mmhg.
Contraindications
1.
Severe tachycardia
2.
Dissecting aortic aneurysm
3.
Heart failure with high cardiac output.
4.
Cor pulmonale
5.
Myocardial insufficiency due to mechanical
obstruction
6.
Coronary artery disease
7.
Idiopathic SLE
8.
Patient with recent MI
