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Gynaecology & Obstetrics Management and Long-Term Consequences 1d941c9a

Antihypertensive of choice in pregnancy is:

A
Hydralazine
B
Propranolol
C
Alpha methyl dopa
D
Labetalol
High-Yield Explanation
Ref: Dana Textbook of Obstetrics, 5th ed pg 506 Explanation: See the following table Antihypertensives Used in Pregnancy MOA Side effects Remarks Methyl dopa Centrally acting anti-adrenergic * Drowsiness * Headache * Postnatal depression * Postural hypotension * Liver dysfunction * Leukopenia * Hemolytic anemia Contraindicated in patients taking * MAO inhibitors * Lithium * Liver failure * Positive Coombs test Clonidine Centrally acting sympathetic inhibitor * Drowsiness * Dry mouth * Dry eyes * Nausea * Reduced fetal heart rate Sudden stoppage should be avoided due to pressor effect Oxprenolot Beta blocker * Nightmares Labetalol Alpha and beta blocker * Worsening asthma * Cough * Nightmares * Bradycardia Contraindicated in asthmatics Avoided in * Pbemochoromocytoma * Heart failure, bradycardia * Peripheral vascular disease * Raynaud's phenomenon Nifedipine Calcium channel blocker * Headache * Edema * Palpitations * Nausea * Dizziness Metabolised through CYT P450-3A4 - Possible interaction with phenytoin and cisapride Hydralazine Peripheral vasodilator * Flushing * Palpitations * Headache * Nausea 2nd or 3rd line agent. Can cause autoimmune lupus

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