148.Drug of choice for pregnancy-induced hypertension is:(AIIMS November 2015, May 2015)
Ans. d. Alpha-methyldopa (Ref: Williams Obstetrics 24/e p100; Dutta 7/e p228: Goodman Giffman 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 anti hypertensive 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 p773"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 tittle 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 Choice* DOC for malaria in pregnancy* ChioroquineQ* DOC for anticoagulation in pregnancy* HeparinQ* Antihypertensive of choice in pregnancy* Alpha-methyldopaQ* Antihypertensive of choice for hypertensive crisis in pregnancy* LabetalolQ* DOC for nausea in pregnancy* Doxylamine & pyridoxineQ* Analgesic of choice during pregnancy* AcitoaminophenQ* Anti-epileptic of choice during pregnancy* PhenobarbitoneQ
Atenolol
Nitroprusside
Enalapril
Alpha-methyldopa
Management and Long-Term Consequences