Pharmacology: Antihypertensive Medication – IV PRN (As Needed)

Hydralazine

• Mechanism of Action: Direct Vasodilator
• Dosing: 10-20 mg Every 4-6 Hours as Needed
• Timing:
  • Onset: 5-30 Minutes
  • Duration: 2-6 Hours
• Contraindications:
  • Hypersensitivity
  • Coronary Artery Disease (CAD)
  • Mitral Valve Rheumatic Heart Disease

Labetalol

• Mechanism of Action: Beta Blocker
• Dosing: 5-20 mg Every 10 Minutes as Needed
• Timing:
  • Onset: 5-10 Minutes
  • Duration: 4-6 Hours
• Contraindications:
  • Severe Bradycardia
  • 2^nd/3^rd Degree Heart Block
  • Cardiogenic Shock
  • Decompensated Heart Failure
  • Bronchial Asthma or History of Obstructive Airway Disease
  • Hypersensitivity

Enalaprilat

• Mechanism of Action: Angiotensin Converting Enzyme (ACE) Inhibitor
• Response is Unpredictable Due to Variable Plasma Volume & Plasma Renin Activity
• Dosing: 1.25 mg Every 6 Hours
  • Can Use Up to 5 mg per Dose if Needed
• Timing:
  • Onset: 15 Minutes
  • Duration: 6 Hours
• Contraindications:
  • Pregnancy
  • Severe Renal Artery Stenosis
  • Severe Hyperkalemia
  • Hypersensitivity
• Generally Avoid ACE Inhibitors in Surgery Patients – Increased Difficulty Managing Blood Pressure Intraoperatively