Fatal Side Effects
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Generic Name, Brand Names, What is ?,
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What Are Hydroxyurea's Common Side Effects? Hydroxyurea is a medication frequently used in the management of sickle cell disease, providing patients with a means to alleviate painful episodes and reduce the necessity for blood transfusions. In this informative video, we will discuss the common side effects associated with hydroxyurea, allowing viewers to gain a better understanding of what to expect while undergoing treatment. We will cover various side effects, including the impact on blood cell production, gastrointestinal discomfort, skin and hair changes, and other symptoms that may arise during therapy.
Monitoring health while on hydroxyurea is essential, and we will outline the importance of regular blood tests and consultations with healthcare providers. By discussing these aspects, we aim to equip patients and caregivers with the knowledge needed to manage treatment effectively. Our goal is to support individuals living with sickle cell disease as they navigate their healthcare journey.
Join us for this important discussion, and don’t forget to subscribe to our channel for more helpful information about sickle cell disease and its management strategies.
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About Us: Welcome to the Sickle Cell Wellness Guide, your go-to resource for understanding Sickle Cell Disease and managing its symptoms. Our channel focuses on providing clear and informative content about Sickle Cell Anemia, pain management strategies, treatment options like Hydroxyurea therapy, and blood transfusions for Sickle Cell. We aim to help individuals and families navigate living with inherited blood disorders by addressing common concerns and questions related to Sickle Cell disease crisis management and available support resources. The content provided is for general informational and educational purposes only. It is not intended to substitute for professional medical advice, diagnosis, or treatment. Never disregard professional medical advice or delay seeking it because of something you have seen in this content. Never rely on this information in place of consulting with qualified healthcare professionals. The creators and distributors of this content are not responsible for any adverse effects or consequences resulting from the use of any suggestions, preparations, or procedures described in this material. Always consult with your healthcare provider before starting any new health-related practice or program.
#Hydroxyurea #bloodcancer #sicklecellanemia #hematologist #drkarunakumar
In this Video Dr Karuna Kumar explains about a tablet called Hydroxyurea , it's usage in blood disorders and it's sideeffects.
Dr. Karuna Kumar Consultant Hematologist Hemat Oncologist & Bone Marrow Transplant Physician is a renowned Hematologist located in Hyderabad, India. This Channel is to bring in expert medical advice to maintain a good health and well being. Dr. Karuna Kumar will also address key issues , diseases related to Hematology and how to overcome such difficulties in life through proper medical treatments.
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Is Hydroxyurea A Chemotherapy Drug? In this informative video, we will discuss the role of hydroxyurea in cancer treatment and its applications beyond oncology. Hydroxyurea is a medication that falls under the category of antimetabolites, which are designed to interfere with cell growth. By understanding how hydroxyurea functions, we can better appreciate its significance in managing certain types of cancer and its additional use in treating conditions like sickle cell anemia.
Throughout the video, we will cover the specific cancers that hydroxyurea targets, including chronic myelogenous leukemia and locally advanced squamous cell carcinomas of the head and neck. We will explain the mechanism of action of this drug, including its effects on DNA production and cell division. Additionally, we will discuss the importance of monitoring patients on hydroxyurea due to its narrow therapeutic index, ensuring safety and effectiveness during treatment.
Whether you are a patient, caregiver, or simply interested in learning more about cancer therapies, this video will provide you with essential information. Join us for this enlightening discussion, and don’t forget to subscribe to our channel for more educational content on oncology and related health topics.
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About Us: Welcome to the Oncology Support Network, your trusted source for comprehensive information and support in the field of oncology. Our channel is dedicated to empowering patients, caregivers, and healthcare professionals with the latest insights on cancer treatment, research breakthroughs, and wellness strategies. The content provided is for general informational and educational purposes only. It is not intended to substitute for professional medical advice, diagnosis, or treatment. Never disregard professional medical advice or delay seeking it because of something you have seen in this content. Never rely on this information in place of consulting with qualified healthcare professionals. The creators and distributors of this content are not responsible for any adverse effects or consequences resulting from the use of any suggestions, preparations, or procedures described in this material. Always consult with your healthcare provider before starting any new health-related practice or program.
Srdan Verstovsek, MD, discusses why he selects hydroxyurea as cytoreductive therapy in this patient with polycythemia vera and provides insight into caring for patients throughout therapy.
For more resources and information regarding anticancer targeted therapies: http://targetedonc.com/
The "JAK Inhibitors for the Successful Management of Patients with Polycythemia Vera” symposium was recorded at the 2015 US Focus on Myeloproliferative Neoplasms and Myelodysplastic Syndromes Congress held in Alexandria, VA, August 28-29, 2015. This symposium highlights key clinical data and recommendations related to the diagnosis, prognosis and therapy of patients with polycythemia vera and the integration of JAK inhibitors into clinical practice.
In this presentation, Dr. Srdan Verstovsek argues that JAK inhibitors should not be limited to hydroxyurea-resistant or intolerant patients.
Earn accreditation for an activity that is supplementary to this webcast at the following location:
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© 2015 Imedex, LLC.
Hydroxyurea Capsule : Therapeutic Uses, Warning and Precautions, Interactions, Directions for Use, Side Effects and Storage. Find out which brands carry Hydroxyurea Capsule here - https://www.netmeds.com/generics/hydroxyurea-500mg
Hydrea is a chemotherapy medicine most commonly used to treat a cancer of the blood cells called chronic myeloid leukaemia, but is also used to treat cervical cancer and some other blood disorders.
Hydrea capsules contain the active ingredient hydroxycarbamide.
The exact way in which hydroxycarbamide works is unclear, but it appears to interfere with the synthesis of DNA inside cells. It therefore stops cells from growing and multiplying, which stops the growth of cancerous tissue.
If you would like to find out more visit:
http://www.lynchspharmacy.com/....medicine/hydrea-hydr
http://www.lynchspharmacy.com
You can also visit Lynch's Pharmacy in Broadale, Maryborough Hill, Cork.
Please note that this video is meant for educational purposes only, and should not be used as a means to diagnose any health condition. You should always consult your doctor if you have any concerns regarding your health or medication.
Thank you for watching!
Top MPN specialist John Mascarenhas, MD of Mt. Sinai, talks about the current, major treatments for MPNs, specifically myelofibrosis (MF), polycythemia vera (PV), and essential thrombocythemia (ET), including hydroxyurea and newer drugs like ropeginterferon (Besremi). Dr. Mascarenhas also describes common side effects.
Featuring: John Mascarenhas, Dir., Adult Leukemia Program, Tisch Cancer Institute, Mt. Sinai & Professor, Icahn School of Medicine
Full story & transcript → Updated Soon at www.ThePatientStory.com
The interview has only been edited for clarity.
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Contents Of This Video:
00:00 - intro
00:26 - What are current treatment options?
02:00 - Tell us about hydroxyurea
04:25 - Other common MPN treatments & Side Effects
06:10 - How are these different treatments given?
08:00 - Most promising emerging treatments for MPNs
10:15 - Shift in treating MPNs → combinations?
12:09 - Determining myelofibrosis prognosis
13:43 - Determining real-world benefits of fedratinib when ruxolitinib fails
____________________________
#ThePatientStory #myeloma #MPN #Cancerexperts #Oncologists #Cancerstories #doctors #Myelofibrosis #PolycythemiaVera #EssentialThrombocythemia
As recent discoveries have the potential to change the paradigm of how MPN and MDS are diagnosed and treated, it is imperative that healthcare professionals who treat these diseases are provided expert review of the most pertinent clinical data pertaining to prognosis, diagnosis, therapy and disease management and guidance for their optimal integration into everyday clinical practice.
The US Focus on Myeloproliferative Neoplasms and Myelodysplastic Syndromes 2015 provides a platform to resolve many of the clinical challenges for diagnosis and treatment through presentations and interactive discussions of the latest clinical and research findings pertaining to MPN and MDS. Topics that will be deliberated include updates in therapeutic interventions of MDS, polycythemia vera, essential thrombocytopenia and myelofibrosis.
In this presentation, Dr. Srdan Verstovsek discusses hydroxyurea intolerance/resistance in polycythemia vera.
A continuing education program is offered as a supplement to this webcast at the following location:
http://elc.imedex.com/Shared/S....ervices/ActivityRedi
© 2015 Imedex, LLC.
Read below for Selected Safety Information. Hematologist-oncologist Gary Grad, MD, addresses the challenges that patients with polycythemia vera (PV) may experience when treated with a chemotherapy medicine called hydroxyurea. He explains that for some adults, hydroxyurea does not control blood counts well enough, while others cannot tolerate the side effects. Dr. Grad explains that PV patients treated with hydroxyurea should track their blood counts, talk with their Healthcare Professional, and ask about a targeted therapy treatment option such as Jakafi® (ruxolitinib).
This video is intended for informational use only, and is not designed to replace the medical advice of your Healthcare Professional.
Jakafi is a prescription medicine used to treat adults with polycythemia vera who have already taken a medicine called hydroxyurea and it did not work well enough or they could not tolerate it. Jakafi is also used to treat adults with certain types of myelofibrosis.
Selected Safety Information
Jakafi can cause serious side effects including low blood counts and infection. Some people who take Jakafi have developed certain types of non‐melanoma skin cancers. Increases in blood cholesterol levels can also occur. In patients who took another JAK inhibitor to treat rheumatoid arthritis, there was an increased risk of potentially fatal cardiovascular events like heart attack or stroke in patients with risk factors for these events who smoke now or smoked in the past, as well as an increased risk of blood clots in legs or lungs and new (secondary) cancers like lymphoma, especially in patients who smoke now or smoked in the past. The most common side effects of Jakafi for certain types of myelofibrosis and PV include: low platelet or red blood cell counts, bruising, dizziness, headache, and diarrhea. Call your doctor for medical advice about side effects.
To learn more about these and other risks, please read the Important Safety Information at https://www.jakafi.com/.
Please see the Full Prescribing Information at https://www.jakafi.com/pi/pi, which includes a more complete discussion of the risks associated with Jakafi.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
You may also report side effects to Incyte Medical Information at 1-855-463-3463.
Sponsored by Incyte Corporation. Jakafi is a registered trademark of Incyte.
© 2020, Incyte Corporation. MAT-JAK-03738 01/22
Cathy reviews the following medications: Vasodilators (nitroprusside) and Antianginal medications (nitroglycerin, isosorbide mononitrate, isosorbide dinitrate).
Our Pharmacology video tutorial series is taught by Cathy Parkes BSN, RN, CWCN, PHN and intended to help RN and PN nursing students study for their nursing school exams, including the ATI, HESI and NCLEX.
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0:08 Vasodilators: Nitroprusside
0:16 Mode of Action
0:36 Side Effects
1:39 Nursing Care
2:01 Medication for Angina
2:28 Side Effects
3:07 Patient Teaching
3:42 Administration
4:24 What’s Next?
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Is Hydralazine Safe To Use During Pregnancy? Managing high blood pressure during pregnancy is a critical concern for many expectant mothers and healthcare professionals. In this informative video, we will discuss the use of hydralazine, a medication often employed to treat severe hypertension and hypertensive crises that can occur during pregnancy. We will cover how hydralazine works, its administration in emergency situations, and the importance of medical supervision when using this medication.
Additionally, we will highlight the potential risks and side effects associated with hydralazine for both the mother and the fetus. Understanding these factors is essential for ensuring the health and safety of both parties during pregnancy. We will also touch on the significance of close monitoring of vital signs and fetal health when hydralazine is administered.
Whether you are a healthcare provider, a first responder, or an expectant mother, this video is designed to provide you with essential information about the safe use of hydralazine in pregnancy. Join us for this important discussion, and don’t forget to subscribe to our channel for more helpful content on first responders medicine and maternal health.
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About Us: First Response Medicine is your essential resource for all things related to emergency and critical care. Our channel is dedicated to providing clear and practical information on emergency medicine, covering topics such as trauma management, life-saving procedures, and the latest in critical care practices.
Please note that all content is for informational purposes only and should not be considered medical advice. Always conduct your own research and consult with professionals when necessary. The content provided is for general informational and educational purposes only. It is not intended to substitute for professional medical advice, diagnosis, or treatment. Never disregard professional medical advice or delay seeking it because of something you have seen in this content. Never rely on this information in place of consulting with qualified healthcare professionals. The creators and distributors of this content are not responsible for any adverse effects or consequences resulting from the use of any suggestions, preparations, or procedures described in this material. Always consult with your healthcare provider before starting any new health-related practice or program.
What Are The Side Effects Of Hydralazine And Hydroxyzine? In this informative video, we will discuss the side effects associated with two commonly prescribed medications: Hydralazine and Hydroxyzine. These medications, while similar in name, serve different purposes in the management of health conditions. Understanding the potential side effects of each medication is essential for anyone who may be prescribed them.
We will outline the common side effects you might encounter with Hydralazine, which is primarily used to manage high blood pressure. Additionally, we'll cover the side effects linked to Hydroxyzine, an antihistamine often prescribed for anxiety and allergic reactions. Knowing what to expect can help you communicate effectively with your healthcare provider and ensure safe medication use.
It’s also important to discuss the serious side effects that can arise from both medications, as well as the importance of distinguishing between them to avoid medication errors. If you or someone you know is taking either of these medications, this video is a must-watch.
Join us for this essential discussion, and don’t forget to subscribe to our channel for more helpful information on medications and health practices.
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About Us: Welcome to Pharmaceutical Insights! Our channel is dedicated to providing clear and informative content on a variety of topics related to pharmaceutical drugs, prescription medications, over-the-counter medicines, drug side effects, and medication safety. We also discuss medical treatments, alternative medicine, and pain management drugs, ensuring you have access to the information you need to make informed health decisions. The content provided is for general informational and educational purposes only. It is not intended to substitute for professional medical advice, diagnosis, or treatment. Never disregard professional medical advice or delay seeking it because of something you have seen in this content. Never rely on this information in place of consulting with qualified healthcare professionals. The creators and distributors of this content are not responsible for any adverse effects or consequences resulting from the use of any suggestions, preparations, or procedures described in this material. Always consult with your healthcare provider before starting any new health-related practice or program.
Hello!
Here is a short guide on how to treat hypertension using hydralazine (Apresoline). I highlighted some side effects and how to use points in this video. If you have other questions regarding the medications, please be sure to click the link down below to get recommendations from a healthcare professional;
www.demirxcare.com
Thanks for watching and STAY TUNED!
Hit your like and subscribe button to support us as we provide educating content for you.
“God has given each of you a gift from his great variety of spiritual gifts. Use them well to serve one another.”
1 Peter 4:10 NLT
https://www.bible.com/116/1pe.4.10.nlt
This information should not be used to decide whether or not to take this medicine or any other medicine. Only a personal healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.
https://usmleqa.com/
http://usmlefasttrack.com/?p=432
cgmp, vasodilates, afterload reduction, severe hypertension, chf, pregnancy, methyldopa, beta blocker, reflex tachycardia, lupus like syndrome, compensatory, First Aid, for, USMLE, Step 1, wiki, define, wikipedia,
This is the 4th fourth video in Pharmacology section dedicated to an important topic.
Direct Acting Vasodilators
Pharmacology, antihypertensive medications.
You will come up to know most high yield information about Hydralazine and Minoxidil.
It's medical series videos dedicated for USMLE, COMLEX, MCCQE, NCLEX and other medical board license exam.
What are their classifications?
What is the mechanism of action?
Indications and best recommended indication for each drug.
Side effects of each drug.
Quiz will come soon like Simulated Board question.
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We added light warm music in the background, hope it adds something to the video and it's not distracting. Let us know what are your opinions about the music?
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You missed the 1st Pharmacology video:
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What Are Hydralazine's Side Effects? In this informative video, we discuss the side effects associated with hydralazine, a medication commonly used to treat high blood pressure during emergencies. Understanding the potential side effects is essential for anyone considering this treatment, especially in critical situations. We will cover both common and serious side effects, helping you to be aware of what to expect when using hydralazine.
From headaches and gastrointestinal issues to cardiovascular reactions, it’s important to know how this medication can impact your body. We will also highlight the significance of monitoring patients closely when hydralazine is administered, particularly in an intravenous form for rapid action. Additionally, we’ll touch on the risks of sudden discontinuation and the importance of consulting healthcare professionals for safe management.
Whether you are a patient, a caregiver, or simply someone interested in learning more about hypertension treatments, this video aims to provide you with essential information. Join us as we break down the side effects of hydralazine and ensure you have the knowledge needed for safe treatment. Subscribe to our channel for more helpful content on hypertension and related topics.
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About Us: Welcome to Hypertension Help Hub, your go-to channel for everything related to high blood pressure. Here, we provide clear and concise information on High Blood Pressure Basics, Causes of Hypertension, Symptoms, Blood Pressure Monitoring, and Lifestyle Changes for Hypertension. We cover essential topics such as the DASH Diet, Medications for High Blood Pressure, and effective strategies for managing stress to support heart health. Our goal is to equip you with practical tips for Hypertension Prevention and ways to take control of your well-being. The content provided is for general informational and educational purposes only. It is not intended to substitute for professional medical advice, diagnosis, or treatment. Never disregard professional medical advice or delay seeking it because of something you have seen in this content. Never rely on this information in place of consulting with qualified healthcare professionals. The creators and distributors of this content are not responsible for any adverse effects or consequences resulting from the use of any suggestions, preparations, or procedures described in this material. Always consult with your healthcare provider before starting any new health-related practice or program.
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How Are Hydralazine Side Effects Managed? In this informative video, we will discuss the management of side effects associated with hydralazine, a medication commonly used to treat high blood pressure, especially in urgent situations. Understanding how medical professionals address these side effects is essential for anyone considering or currently using this medication. We will cover the common side effects that patients may experience, ranging from mild issues like headaches and dizziness to more serious complications that require immediate attention.
You’ll learn about various strategies employed by healthcare providers to manage these side effects effectively, including dose adjustments and combination therapy with other medications. Monitoring for serious symptoms is a critical aspect of treatment that we will highlight, ensuring that patients are aware of what to look for during their course of therapy.
Additionally, we will touch on the importance of patient education in managing these side effects and what steps should be taken if side effects occur. Whether you are a patient, caregiver, or simply interested in hypertension treatments, this video will provide essential information for understanding how hydralazine side effects are managed.
Join us for this detailed discussion, and don't forget to subscribe to our channel for more helpful content on hypertension and related health topics.
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About Us: Welcome to Hypertension Help Hub, your go-to channel for everything related to high blood pressure. Here, we provide clear and concise information on High Blood Pressure Basics, Causes of Hypertension, Symptoms, Blood Pressure Monitoring, and Lifestyle Changes for Hypertension. We cover essential topics such as the DASH Diet, Medications for High Blood Pressure, and effective strategies for managing stress to support heart health. Our goal is to equip you with practical tips for Hypertension Prevention and ways to take control of your well-being. The content provided is for general informational and educational purposes only. It is not intended to substitute for professional medical advice, diagnosis, or treatment. Never disregard professional medical advice or delay seeking it because of something you have seen in this content. Never rely on this information in place of consulting with qualified healthcare professionals. The creators and distributors of this content are not responsible for any adverse effects or consequences resulting from the use of any suggestions, preparations, or procedures described in this material. Always consult with your healthcare provider before starting any new health-related practice or program.
What Are The Side Effects Of Hydralazine? In this informative video, we will cover the side effects of hydralazine, a medication commonly used to manage high blood pressure, especially in emergency situations. Understanding the potential side effects is essential for both patients and first responders. We will discuss the common side effects that patients may experience, including headaches, gastrointestinal issues, and changes in appetite. Additionally, we will highlight more serious side effects that require immediate medical attention, such as chest pain and lupus-like symptoms.
First responders play a vital role in monitoring patients on hydralazine, and knowing what to look for can make a significant difference in patient outcomes. We’ll also emphasize the importance of educating patients about these side effects and when to seek medical help. This knowledge is crucial in ensuring safety and effective care during hypertensive crises.
Join us for this essential discussion, and don’t forget to subscribe to our channel for more helpful information on first responders’ medicine and patient care.
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About Us: First Response Medicine is your essential resource for all things related to emergency and critical care. Our channel is dedicated to providing clear and practical information on emergency medicine, covering topics such as trauma management, life-saving procedures, and the latest in critical care practices.
Please note that all content is for informational purposes only and should not be considered medical advice. Always conduct your own research and consult with professionals when necessary. The content provided is for general informational and educational purposes only. It is not intended to substitute for professional medical advice, diagnosis, or treatment. Never disregard professional medical advice or delay seeking it because of something you have seen in this content. Never rely on this information in place of consulting with qualified healthcare professionals. The creators and distributors of this content are not responsible for any adverse effects or consequences resulting from the use of any suggestions, preparations, or procedures described in this material. Always consult with your healthcare provider before starting any new health-related practice or program.
In this episode, I discuss a medication known as hydralazine (Apresoline).
My book is now available! It discusses my experience with Bipolar Disorder.
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💊 Is Hydralazine the right medication for YOU? If you're struggling with high blood pressure or heart failure, this medication might be an option—but it's not for everyone! In this video, Pharmacist Michael breaks down:
✔️ How Hydralazine works to lower blood pressure
✔️ Who should (and shouldn’t) take it
✔️ Proper dosing & precautions to avoid serious side effects
✔️ Dangerous drug interactions to watch out for
✔️ How to safely manage side effects
🚨 DON’T stop taking Hydralazine suddenly! Learn why rebound hypertension can be life-threatening and how to taper off safely if needed.
🔔 Make sure to watch until the end for crucial tips on monitoring your blood pressure, avoiding risky medication combos, and getting the best results from your treatment!
🔹 Timestamps:
00:00 Intro – Is Hydralazine Right for You?
00:31 What is Hydralazine & who Needs It?
01:13 How to Take Hydralazine Correctly
02:45 Staying Hydrated & Monitoring Blood Pressure
03:29 Side Effects - What You Need to Watch For!
04:52 Serious but Rare Side Effects
07:37 Precautions & Drug Interactions
13:13 Is Hydralazine for YOU?
📌 Resources & Helpful Links:
🔹 Blood pressure monitors I recommend: https://amzn.to/3ETgaZ2
💬 Have you taken Hydralazine? Let me know in the comments how your experience has been! And if you found this video helpful, LIKE & SHARE to help others stay informed.
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This video cannot and does not contain medical/health advice. The medical/health information is provided for general informational and educational purposes only and is not a substitute for professional advice. Accordingly, before taking any actions based upon such information, we encourage you to consult with the appropriate professionals. We do not provide any kind of medical health advice. THE USE OR RELIANCE OF ANY INFORMATION CONTAINED IN THIS VIDEO IS SOLELY AT YOUR OWN RISK.
Hydralazine is an antihypertensive agent used for the management of essential hypertension or severe hypertension associated with conditions requiring immediate action, heart failure, and pre-eclampsia or eclampsia.
In this video, let’s find found:
What is hydralazine?
What is hydralazine used for?
Contraindication
What are the side effects of taking hydralazine?
How does hydralazine work?
How to use hydralazine?
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#hydralazine #vasodilators #Apresoline
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This video explains some common side effects of hydralazine tablets.
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Hydralazine
Generic Name: hydralazine
Trade Name: Apresoline
Indication: hypertension
Action: arterial vasodilation by unclarified mechanism
Therapeutic Class: anti-hypertensive
Pharmacologic Class: vasodilator
Nursing Considerations
may cause tachycardia, sodium retention, arrhythmias, angina
use caution with MAOIs
monitor blood pressure
instruct patient on how to take blood pressure
In this episode, I discuss a medication known as hydralazine (Apresoline).
My book is now available! It discusses my experience with Bipolar Disorder.
The Fifth Episode - Inside The Manic Mind.
Find it here:
BookBaby (best way to support this project):
https://store.bookbaby.com/book/the-fifth-episode
Amazon:
https://www.amazon.com/Fifth-Episode-Inside-Manic-Mind/dp/1667843451/ref=sr_1_12?crid=26PVK90TTXRBO&keywords=the+fifth+episode+paperback&qid=1654191898&sprefix=the+fifth+episode+paperback%2Caps%2C61&sr=8-12
Barnes & Noble:
https://www.barnesandnoble.com..../w/the-fifth-episode
Support the channel on Patreon:
https://www.patreon.com/DrugTalk
Twitter: @talkaboutdrugs
Instagram: @garrett.campb
Connect on Facebook:
https://www.facebook.com/talkaboutdrugs
For information purposes only!