Onset of action after IM or IV administration is 5 to 15 mins followed by a progressive and often precipitous fall in BP that can last up to 12 hours. Its maximum effect is usually between 10–80 minutes. 2 to 3 mg boluses may allow for a more controlled reduction in BP in the peri-operative setting. refl.in/ea
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A reflex tachycardia may result from the reduction in SVR, resulting in an increased cardiac output. It may therefore not be a good choice in a patient with ischemic heart disease who may not tolerate the resulting increased myocardial oxygen consumption. refl.in/ea
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Because of the potent vasodilation of cerebral vessels caused by hydralazine, there may be an increase in intracranial pressure (ICP). Although the clinical importance of this action is unclear, hydralazine is best avoided in patients with intracranial processes in which increased ICP is an issue. refl.in/ea
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