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 Pre Op Meds: y y y y y Hydralazine 5 mg TIV slow push PRN for BP > 160/100 q 30 mins. Methyldopa 250 mg 1 tab.

TID (6AM - 2PM ± 6PM) Multivitamins Cap. OD FeSo4 Tab OD Davidilan 10 mg TID

CLASSIFICATION Antihypertensive ALTERNATE NAMES APRESOLINE/ Hydralazine INDICATIONS y y treatment of severe hypertension when the oral route is not feasible; hypertensive emergencies treatment of hypertensive complications of pregnancy (pre-eclampsia, eclampsia)

RECONSTITUTION AND STABILITY y y add 1mL sterile water for injection to give 20mg/mL solution diluted solutions stable for 24 hrs at room temperature

COMPATIBILITY y y y compatible with NS, RS; the manufacturer no longer recommends dextrose solutions as a diluent due to a yellowish colour which appears slowly after mixing; the colour does not alter the hypotensive effects compatible via Y-site with dobutamine, heparin, hydrocortisone, potassium chloride incompatible with aminophylline, ethacrynic acid

ROUTES OF ADMINISTRATION y y y y IM - deeply into a large muscle; give only if IV route unavailable IV direct - for hypertensive urgency: in at least 20 mL of NS at a rate not exceeding 5 mg/minute IV intermittent - in 50mL NS over 15 minutes IV infusion - 100mg in 250-1000mL NS

with peak effects in 10-80 minutes and a duration of action of 2-6 hours onset of hypotensive effect is delayed with IM administration (20-40 minutes) early adverse effects (usually transient) include hypotension.1 mg/kg followed by a continuous infusion of 1. close monitoring of blood pressure and heart rate is required during IV use.NOT epinephrine IMPORTANT IMPLICATIONS y y y y y y onset of hypotensive effect is 5-20 minutes. antidote for excessive hypotension. norepinephrine or ephedrine . a drug used to treat pregnancy-induced hypertension. usual: y y y IM: 10-50mg every 1-4 hours as necessary to desired response IV: 10-20 mg repeated every 1-4 hours as necessary to desired response IV infusion: loading dose of 0. Side effects of methyldopa may include drowsiness. tachycardia. followed by 5-20 mg every 20-30 minutes as necessary 20-25 mg IV is approximately equal to 75-100 mg of oral hydralazine POTENTIAL HAZARDS OF PARENTERAL ADMINISTRATION y fall in blood pressure may be dramatic during and after IV use. idiopathic systemic lupus erythematosis (SLE) use with caution in patients with increased intracranial pressure dosage adjustments are recommended in renal impairment and in slow acetylators . headache. This drug is considered a safe choice because it does not alter cardiac blood flow to the kidneys or the fetus.Direct IV route restricted to nurses in Special and Critical Care areas and the Telemetry unit. On general nursing units the direct IV route must be administered by a physician. Do not stop taking methyldopa abruptly. belongs to a classification of drugs known as anti-hypertensives.VH & HSC ADMINISTRATION POLICY Infusions restricted to Critical Care Areas B . tachycardia. it may cause an unsafe fluctuation in your blood pressure.hypotensive effects are enhanced by other antihypertensives Methyldopa y Methyldopa (Aldomet). H . headache.The IV infusion administration rate must be controlled by an automated infusion control device DOSAGE Adults. . dizziness contraindicated in patients with coronary artery disease.5-5 mcg/kg/minute Pre-eclampsia/eclampsia: 5-10 mg initially. muscle weakness and swelling of the feet or ankles. Monitor blood pressure and pulse rate 15 and 30 minutes after each dose. palpitations.

It is claimed to delay labour and prolong pregnancy. respiratory distress and hypocalcaemia (low calcium levels in blood). In other words it should only be used if pre-term labour has already started.y Methyldopa works by controlling impulses along certain nerve pathways. safer agents such as salbutamol and ritodrine are used but like isoxsuprine they have no prophylatic use. thus preventing to go on earlier labor Duvadilan Retard is the brand name of a medicine called isoxsuprine. It is not clear as to why you were given Duvadilan Retard during your previous pregnancy unless labour had actually started before 34 weeks. it relaxes blood vessels so that blood passes through them more easily. Acetyl Salicylic Acid is another name of aspirin. Even for pre-term delivery. Medcines to be given only when clearly indicated. Among others. The golden principle is: least medication during pregnancy. In the past this medicine was used to stop pre-term delivery. This helps to lower blood pressure. scientific evidence in support of this theory is lacking. Duvadilan Isoxsuprine 10mg tablet y y Will stop the contraction of the uterus. Another reason for giving aspirin is pregnancy-induced high blood pressure. bloating and pain). As a result. it relaxes the muscles of the uterus. However it has no preventive role. An injection was given if the labour started ahead of 34 weeks followed by tablets. Babies born to women who were taking isoxsuprine have suffered from ileus (slow movement of intestine resulting in constipation. However it can cause bleeding disorders in infants born to mothers who take aspirin. . However firm. It has many actions on many organs.