Which of the following antihypeensives is NOT used in the management of Pregnancy Induced Hypeension in the first trimester
Atenolol is not recommended for the management of Hypeension in pregnancy. Atenolol has risk of growth restriction when staed in first or second trimester and is not recommended if breast feeding. Atenolol Labetolol Hydralazine Nifedipine Mechanism Beta Blocker Beta Blocker Vasodilator Calcium Channel blocker Preganancy No; Avoid in first and second trimester. Associated with fetal growth restriction and bradycardia, reduces Uteroplacental blood flow Yes; May be used as First line therapy can be given intravenously for rapid control of severe resistant hypeension Yes; Used intravenously for rapid blood pressure control. Avoid rapid intravenous bolus because of risk of hypotension Yes; Available in sho acting forms for rapid blood pressure control and long acting for long-term maintanence therapy. May be used simultaneously with magnesium 99 sulphate. May inhibit labor. Should be Discontinued before labor. Side-effects Risk of fetal growth restriction and bradycardia in pregnancy Tachycardia May be associated with neonatal thrombocytopenia Headache Antihypeensive Drugs in Pregnancy: First line Agents: Methyl-Dopa Labetalol Second Line Agents: Hydralazine Nifedipine (May inhibit Labor) Clonidine and Prazosin Diuretics (Some consider second line while some advice to avoid) Preferably avoided Atenolol Diuretics Nitroprusside (Only considered for life-threatening severe hypeension) Ref: KDT 7th edition Pgno: 572-574
Hydralazine
Atenolol
Labetolol
Nifedipine
Cardiovascular system