Hydralazine

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Hydralazine , sold under the trademark Apresoline among others, is a drug used to treat high blood pressure and heart failure. These include high blood pressure in pregnancy and very high blood pressure that produce symptoms. It has been found to be very useful in heart failure along with isosorbide dinitrate in people of African descent. This is given by mouth or by injection into blood vessels. The effects usually begin around 15 minutes and last up to six hours.

Common side effects include headache and rapid heartbeat. It is not recommended in people with coronary artery disease or in those with rheumatic heart disease that affects mitral valve. In those with kidney disease, low doses are recommended. Hydralazine is in the family of drug vasodilators and is believed to work by causing dilation of blood vessels.

Hydralazine was found when scientists at Ciba were seeking treatment for malaria. It was patented in 1949. It's in the List of Essential Medicines of the World Health Organization, the most effective and safe medicines needed in the health system. Wholesale costs in developing countries are around 2.78 to 9.11 USD per month. In the United States the maintenance cost is about 50 to 100 USD per month.

Video Hydralazine

Medical use

Hydralazine is not used as a primary drug to treat hypertension because it stimulates sympathetic reflexes of the heart (baroreceptor reflex). Sympathetic stimulation can increase heart rate and cardiac output, and in people with coronary artery disease may cause angina pectoris or myocardial infarction. Hydralazine can also increase plasma renin concentration, resulting in fluid retention. To prevent these unwanted side effects, hydralazine is usually prescribed in combination with? -blocker (eg, propranolol) and diuretics. Beta-blockers that are licensed to treat heart failure in the UK include bisoprolol, carvedilol, and nebivolol.

Hydralazine is used to treat severe hypertension, but again, this is not a first-line therapy for essential hypertension. However, hydralazine is often used to treat hypertension in pregnancy, with methyldopa.

Hydralazine is commonly used in combination with isosorbide dinitrate for the treatment of congestive heart failure in self-identified African American populations. This preparation, isosorbide dinitrate/hydralazine, is the first race-based prescription drug.

It should not be used in people with tachycardia, heart failure, who have constrictive pericarditis, who have lupus, dissecting aortic aneurysms, or porphyria.

Maps Hydralazine

Adverse effects

Prolonged care may cause a syndrome similar to lupus which can be fatal if symptoms are not noticed and drug treatment stops.

Very common side effects (& gt; 10% frequency) include headache, high heart rate, and palpitations.

Common side effects (1-10% frequency) include flushing, hypotension, angina symptoms, joint pain or swelling, muscle aches, positive tests for ANP, abdominal pain, diarrhea, nausea, and vomiting, and swelling (sodium and water retention).

Interactions

This may potentiate the antihypertensive effect of:

Drugs that have a strong first-pass effect like? -blockers can increase bioavailability of hydralazine. The effect of accelerated heart rate of epinephrine (adrenaline) is increased by hydralazine, which can lead to toxicity.

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Action mechanism

It is a straightforward muscle relaxant act and acts as a vasodilator primarily in arteriolar resistance; The molecular mechanism is unknown in 2011. By relaxing the vascular smooth muscle, the vasodilator acts to reduce peripheral resistance, thereby lowering blood pressure and decreasing afterload.

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Chemistry

Hydralazine is a class of hydrazinophthalazine.

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History

The hydralazine antihypertensive activity was discovered by scientists in Ciba who tried to find a cure for malaria; originally called C-5968 and 1-hydrazinophthalazine; Ciba's patent application was filed in 1945 and issued in 1949, and the first scientific publication of his blood pressure-lowering activity appeared in 1950. This was approved by the FDA in 1953.

It is one of the first antihypertensive drugs to drink.

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Research

Hydralazine has also been studied as a treatment for myelodysplastic syndrome in its capacity as a DNA methyltransferase inhibitor.

src: heartfailure.onlinejacc.org

See also

• Arteriolar vasodilator
• Cadralazine
• Dihydralazine
• Endralazine
• Sodium nitroprusside

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References

Source of the article : Wikipedia