Drug of choice for hypertension in pregnancy:
Ans. c. Methyldopa (Ref: Williams Obstetrics 24/e p100; Dutta 7/e p228, Goodman Gillman 12/e p773, 774; Katzung 12/e p176)Drug of choice for hypertension in pregnancy is methyldopa.Methyldopa is a centrally acting antihypertensive agent. It is a prodrug that exerts its antihypertensive action via an active metabolite. Although used frequently as an antihypertensive agent in the past, methyldopa s significant adverse effects limit its current use largely to treatment of hypertension in pregnancy, where it has a record for safety. " --Goodman Gillman 12/e p 773"Methyldopa is a preferred drug for treatment of hypertension during pregnancy based on its effectiveness and safety for both mother and fetus. The usual initial dose of methyldopa is 250 mg twice daily, and there is little additional effect with doses >2 g/day. "--Goodman Gillman 12/e p774"Methyldopa was widely used in the past but is now used primarily for hypertension during pregnancy. It lowers blood pressure chiefly by reducing peripheral vascular resistance, with a variable reduction in heart rate and cardiac output. " --Katzung 12/e p176Antihypertensives in PregnancySafeContraindicated* LabetaloQ* Alpha methyldopaQ* Calcium channel blockersQ* Hydralazine* Sodium nitroprusside +-* ACE inhibitorsQ* Reserpine* Loratidine Drug of Choice in PregnancyConditionDrug of ChoiceDOC for malaria in pregnancy* ChloroquineQDOC for anticoagulation in pregnancy* HeparinQAnti hypertensive of choice in pregnancy* Alpha-methyldopaQAnti hypertensive of choice for hypertensive crisis in pregnancy* LabetaloQDOC for nausea in pregnancy* Doxylamine and pyridoxineQAnalgesic of choice during pregnancy* AcitoaminophenQAnti-epileptic of choice during pregnancy* PhenobarbitoneQ
Enatapril
Verapamil
Methyldopa
Furosemide
Management and Long-Term Consequences