Hydralazine relaxes smooth muscle and preferentially vasodilates arterioles, creating an afterload reduction. It is indicated in diseases where there is cardiac failure or excess systemic resistance.
Hydralazine is used clinically to treat severe hypertension, however it is not indicated for essential hypertension. It is also a first-line treatment for hypertension during pregnancy (combined with methyldopa).
Hydralazine is indicated for hypertension during pregnancy along with methlydopa.
Along with severe hypertension, hydralazine can be used to treat CHF.
While the mechanism of action of hydralazine is not completely understood, it is thought to work by increasing cyclic GMP levels, which ultimately inhibits contraction in smooth muscle and leads to blood vessel relaxation.
Increases in cyclic GMP levels and inhibition of smooth muscle contraction leads to greater vasodilation of arterioles than veins.
Drug-induced lupus, an autoimmune response caused by chronic use of some drugs, may be seen as a side effect. Patients will likely display anti-histone antibodies.
Reflex tachycardia is a possible side effect, which occurs as a compensatory response to sudden decreased blood pressure to maintain cardiac output. Hydralazine is often coadministered with a beta-blocker to prevent this. Hydralazine is contraindicated in angina and CAD, and can cause angina.
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