To supress lactation in mother with rheumatic fever, Rx of choice is -
Ans. is 'b' Pyridoxine All of the drugs given in the question are used to suppress lactation.But we have to keep in mind that lady is suffering from heart disease and steroidal drugs are contraindicated in patients with heart disease due to fear of thromboembolic phenomenon.It is not specifically mentioned that bromocriptine in contraindicated in patients with heart disease, but postural hypotension is an important adverse effect of bromocriptine. Therefore I have ruled it out.Now we are left with pyridoxine has no effect on CVS and it suppresses lactation by potentiating dopamine (Page, 886, 4/e, KDT).
D-Norgesterol
Pyridoxine
Bromocriptine
DMPA
Pharmacology in Gynaecology