Eclampsia and pre-eclampsia
Michael S. Marsch, Janet M. Rennie, Phillipa A. Groves in Clinical Protocols in Labour, 2020
The signs and symptoms of pre-eclampsia are many and include: visual disturbance; flashing lights; headache; epigastric pain; raised blood pressure (BP); hyper-reflexia; clonus; changes in optic fundi; epigastric or liver edge tenderness; and oedema. BP should be recorded with the cuff at the level of the heart. The diastolic pressure is taken as abolition of heart sounds. Post-delivery the hydralazine should be reduced after 4 h by 1mg/h. If the BP rises during this reduction nifedipine 5-10 mg sublingually may be used as required to control BP. Urine output measurement and urinalysis should be performed hourly. BP measurements should be taken every 15 min using an automated blood pressure recorder and checked manually using a sphigmomanometer and stethoscope every hour. Intensive therapy unit charts should be filled in at least hourly. The hourly fluid intake, urine output and fluid balance, BP central venous pressure, oxygen saturation and blood results should all be recorded, filling in important events.
Chronic heart failure
Ann Richards in Nursing & Health Survival Guide, 2014
Drugs used to treat CHF include: Diuretics – usually furosemide ACE-inhibitors or angiotensin II receptor blockers (ARBs) Hydralazine (a vasodilator drug) in combination with nitrates if intolerant of ACE-inhibitors and ARBs Beta-blockers – reduce the effects of stimulation of the sympathetic nervous system Spironolactone – an aldosterone antagonist Digoxin – usually if atrial fibrillation is present
Pericardial disease
Helen Rimington, John B. Chambers in Echocardiography, 2015
Echocardiography is requested for patients with known or suspected: pericardial effusion ( Table 15.1 ) Table 15.1 Causes of pericardial effusions 1 Common Infection Viral (Coxsackievirus, echovirus, HIV), TB, coxiella Cancer Angiosarcoma, metastases Metabolic Low albumin, hypothyroidism, renal failure Reactive Chest infections especially pneumococcal Systemic inflammatory diseases SLE, rheumatoid arthritis, Sjogren’s syndrome, systemic sclerosis Heart failure Idiopathic Uncommon Post radiation Dressler’s syndrome Autoimmune pericarditis after post cardiac surgery, myocardial inflarction or trauma Direct injury Blunt or sharp chest injury, RF ablation Drugs Isoniazid, minoxidil, hydralazine, phenytoin Aortic dissection pericardial constriction pericarditis.
A simultaneous presentation of drug-induced lupus with drug-induced ANCA vasculitis secondary to hydralazine use in a patient with sarcoidosis
Published in Baylor University Medical Center Proceedings, 2019
Maria Catalina Espinosa, Belicia Ding, Kati Choi, Daniel N. Cohen, Marco Marcelli, Onome Whiteru Ifoeze
Frequently used in the management of hypertension and heart failure, hydralazine is associated with the development of adverse rheumatologic side effects. The authors highlight a unique case of drug-induced lupus and drug-induced anti-neutrophil cytoplasmic antibody (ANCA) vasculitis from hydralazine use in a 50-year-old man with sarcoidosis and hypertension.
Hereditary afibrinogenemia and pulmonary-renal hydralazine-induced vasculitis
Published in Baylor University Medical Center Proceedings, 2019
Ginger Tsai-Nguyen, Ariel M. Modrykamien, Arthur Bredeweg
Combined pulmonary-renal hydralazine-induced vasculitis is rare, and hereditary afibrinogenemia is also rare. We present a case of a 62-year-old man with a history of hereditary afibrinogenemia who presented with hemoptysis and hematuria. Although he had prior episodes of hemoptysis that resolved with repletion of fibrinogen levels, a hydralazine-induced vasculitis was the ultimate cause of his recurrent hemoptysis and hematuria. Hydralazine was held and after transfusion with cryoprecipitate, he was treated with prednisone and rituximab.
Hypertension promotes islet morphological changes with vascular injury on pre-diabetic status in SHRsp rats
Published in Clinical and Experimental Hypertension, 2014
Minoru Satoh, Hajime Nagasu, Yoshisuke Haruna, Chieko Ihoriya, Hiroyuki Kadoya, Tamaki Sasaki, Naoki Kashihara
Hypertensive patients have a higher incidence of new-onset diabetic mellitus than normotensive subjects, and we hypothesized that hypertension induces morphological changes in islets via vascular injury. To test our hypothesis, we administrated hydralazine or irbesartan to spontaneously hypertensive stroke-prone (SHRsp) rats. A greater islet fibrosis was observed in SHRsp rats compared with controls, and irbesartan significantly ameliorated the fibrosis. High fat diet induced glucose intorelance in SHRsp rats and irbesartan but not hydralazine improved glucose torelance. We demonstrate islet morphological changes in hypertensive rats, and our data suggest that angiotensin receptor blockers have the potential to prevent islet injury.
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