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| {{drugbox |
| | #REDIRECT [[Hydralazine#Pharmacology]] |
| | IUPAC_name = 1-hydrazinophthalazine
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| | image = Hydralazine_svg.png
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| | CAS_number = 86-54-4
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| | ATC_prefix = C02
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| | ATC_suffix = DB02
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| | PubChem = 3637
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| | DrugBank =
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| | C=8 | H=8 | N=4
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| | molecular_weight = 160.176 g/mol
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| | bioavailability =
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| | protein_bound =
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| | metabolism = Hepatic
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| | elimination_half-life = 2-4 hours
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| | excretion = Renal
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| | pregnancy_category =
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| | legal_status =
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| | routes_of_administration = Oral, [[Intravenous therapy|intravenous]]
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| }}
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| {{CMG}}
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| __NOTOC__
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| {{Editor Help}}
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| ==[[Hydralazine (patient information)|For patient information, click here]]==
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| ==Overview==
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| '''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.<ref name=Harvey>Harvey, Richard A., Pamela A. Harvey, and Mark J. Mycek. Lippincott's Illustrated Reviews: Pharmacology. 2nd ed. Philadelphia: Lipincott, Williams & Wilkins, 2000. 190.</ref>
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| ==Mechanism==
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| Hydralazine works through a [[cGMP]]-mediated mechanism, resulting in smooth muscle relaxation.<ref name=Bhushan>Bhushan, Vikas, Tao T. Lee, and Ali Ozturk. First Aid for the USMLE Step 1. New York: McGraw-Hill Medical, 2007. 251.</ref>
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| ==Clinical Use==
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| Hydralazine is not used as a primary drug for treating hypertension because it elicits a reflex [[Sympathetic nervous system|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]].<ref name=Harvey/> Hydralazine may also increase [[blood plasma|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]].<ref name=Harvey/>
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| 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]].<ref name=Bhushan/>
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| ==Side effects==
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| Common side effects include:
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| * [[Diarrhea]]
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| * Compensatory [[tachycardia]] due to baroreceptor reflex
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| * [[Headache]]
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| * [[anorexia (symptom)|Loss of appetite]]
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| * [[Nausea]] or [[vomiting]]
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| * [[palpitation|Pounding heartbeat]]
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| * [[Drug-Induced Lupus Erythematosus]]
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| 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.<ref name=Harvey/> Hydralazine is differentially acetylated by fast and slow acetylator phenotypes thus incidence of lupus-like disease in slow acetylators.
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| ==References==
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| <references/>
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| {{Antihypertensives and diuretics}}
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| [[Category:Antihypertensive agents]]
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| [[Category:Hydrazines]]
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| [[Category:Pyridazines]]
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| [[Category:Drugs]]
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| [[hr:Hidralazin]]
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| [[ja:ヒドララジン]]
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