Hey all, welcome back to the real-life pharmacology podcast. The drug of the day today is going to be

hydrolyzine. Brand name is a prescline. And this drug is frequently, well, I would say more infrequently

used in hypertension. And I will talk about, you know, why it isn't, you isn't one of the mainstays of lowering blood

pressure. But first touch on the mechanism of action here. Mechanism of action is pretty simple

in that it directly stimulates the arterials to dilate. So if you remember, if you think of

pipes, and if we open up a

pipe, if we make it bigger, that's going to reduce pressure, which obviously I said these,

this medication can be used for blood pressure lowering purposes. So hypertension is a big one

that this drug is used for.

Off label, it also can be used, and I have seen this before, it can be used in combination

with isosorbide dinitrate or nitrates in reduced ejection fraction heart failure.

So that's another situation where you might see it.

Preferentially, ace inhibitors and ARBs are going to be preferred in heart failure,

but there may be certain situations where patients don't respond to ACEs or ARBs

and or maybe they don't tolerate. So obviously if they don't respond to aces or ARBs and or maybe they don't tolerate.

So obviously if they don't tolerate it, hydrolyzine, again in combo with a nitrate, may be a possible option there.

And then one of those situations that comes up sometimes is patients of African descent, blacks may not respond as well to the blood pressure, lowering effect of ACE inhibitors and ARBs through that system and pathway.

So hydrolyzine in combination in those heart failure patients may be utilized in that situation as well.

I may be able to use this medication in an emergency type situations or maybe one of the options,

particularly in pregnancy. So that's a thing to remember there as well.

Now, why isn't this drug used very often?

The biggest reason why it's, because it is available orally,

...