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Medicine C.V.S 289b60a2

A hypeensive, diabetic is having proteinuria, antihypeensive of choice is-

A
Propanolol
B
Clonidine
C
Enalapril
D
Alpha methyldopa
High-Yield Explanation
a hypeensive along with chronic history of diabetes mellitus and proteinuria ,the drug of choice is alpha methyl dopa.Methyldopa is an aromatic-amino-acid decarboxylase inhibitor in animals and in man. Only methyldopa, the L-isomer of alpha-methyldopa, has the ability to inhibit dopa decarboxylase and to deplete animal tissues of norepinephrine. In man the antihypeensive activity appears to be due solely to the L-isomer. About twice the dose of the racemate (DL-alpha-methyldopa) is required for equal antihypeensive effect. Methyldopa has no direct effect on cardiac function and usually does not reduce glomerular filtration rate, renal blood flow, or filtration fraction. Cardiac output usually is maintained without cardiac acceleration. In some patients the hea rate is slowed. Normal or elevated plasma renin activity may decrease in the course of methyldopa therapy. Methyldopa reduces both supine and standing blood pressure. Methyldopa usually produces highly effective lowering of the supine pressure with infrequent symptomatic postural hypotension. Exercise hypotension and diurnal blood pressure variations rarely occur. ref:Harrison&;s principles of internal medicine,ed 18,pg no 2044

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