Vascular question: hydralazine and AAA
questions for the Vascular types:
You know how you're not supposed to use hydralazine for BP control in AAA, per the 'shearing force' of hydralazine
a) Is that really true? does hydralazine really have a 'shearing force'? How real of a threat is this?
b) What about after repair of the AAA? say patient had it repaired 5 years ago and now just has bad HTN. ok to use hydralazine?
Thanks! (Source: Student Doctor Network)
Source: Student Doctor Network - July 25, 2021 Category: Universities & Medical Training Authors: DrMetal Tags: Surgery and Surgical Subspecialties Source Type: forums
Questions on BP trend
Took me forever to transcribe this on my iPhone...LOL. Anybody have any insight on what is going on with this pt’s bp? If you want further details I can try to pull them, just have to be careful of pt’s PHI. Thanks for your time, everyone!
No supplemental O2 except b/n Day 1, 2000 and 2200. EKG: normal sinus rhythm throughout, with a couple PVCs.
Order: hydrALAZINE (Apresoline) 20 mg/mL injection 10 mg
PRN reasons: systolic blood pressure greater than 170 mmHg
Frequency: q4h PRN...
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Source: Student Doctor Network - May 24, 2021 Category: Universities & Medical Training Authors: nikolaite Tags: Topics in Healthcare Source Type: forums
"Interesting" Practices
Hey all, EM doc here and recently I've recently seen a few practices that I find a little atypical:
1) PRN anti-hypertensives at home. I've seen a number of patients w/ prescriptions, typically hydralazine or clonidine, to be taken only as needed for at home SBPs>180 (in addition to their scheduled antihypertensives). Never saw/heard of this during med school or residency and it seemingly runs counter to most everything I learned about antihypertensive management.
2) I've seen a few...
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Source: Student Doctor Network - November 21, 2020 Category: Universities & Medical Training Authors: turkeyjerky Tags: Family Medicine Source Type: forums
IV hydralazine
A cardiologist today told me that IV hydralazine is a drug which should never be used for anything. Reason is because it has an extremely short duration of action yet extremely rapid onset of action. It is apparently only good for making the numbers look better for your attending, but otherwise exceptionally worthless.
If this is the case, why have I seen an order for "hydralazine IV 10mg IV PRN Psys >160" on so many patients with medicine consult for "hypertension." (Source: Student Doctor Network)
Source: Student Doctor Network - November 1, 2016 Category: Universities & Medical Training Authors: cbrons Source Type: forums
step 2CK: digoxin hyperkalemia
This is a question i found on MTB step 2 ck, it said:
You have a patient with dilated cardiomyopathy secondary to MI in the past, that comes for routine evaluation, is asymptomatic, but with hyperkalemia. He is on lisinopril, furosemide, metoprolol, aspirin and digoxin.
What is the best management?
The answer was to change lisinopril (a IECA, so a possible cause of hyperKalemia) for hydralazine + nitroglycerin. This also lowers mortality, like IECAs, in CHF.
My question is... I remember...
step 2CK: digoxin hyperkalemia (Source: Student Doctor Network)
Source: Student Doctor Network - August 30, 2016 Category: Universities & Medical Training Authors: DrPettans Source Type: forums
