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Flashcards in Antihypertensive therapy in pregnancy Deck (9)
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When do the SOMANZ guidelines recommend commencing antihypertensive therapy in pregnancy?

in all women with systolic BP>160mmHg or diastolic BP >110mmHg
treatment of mild hypertension depends on discretion of clinician and clinical picture


What are the main antihypertensive drugs used in pregnancy?

First line
- methyldopa
- clonidine
- labetalol
- oxepranalol
Second line
- nifedipine
- prazosin
- hydralazine


What is the definition of hypertension in pregnancy

SBP greater than or equal to 140 and/or DBP greater than or equal to 90


What is usual aim of antihypertensive therapy?

- prevention of severe hypertension and eclampsia
- prolong pregnancy to allow for fetal maturation, particularly lung maturation, to reduce risks of birth


What is the mode of action of methyldopa?

- acts centrally to stimulate alpha adrenergic receptors to down regulate stimulation of the peripheral sympathetic nervous system


What is the trade name of methyldopa?

Aldomet or Hydopa


What is the stock strength and usual dose of methyldopa?

- 250mg tablets
- started at 250-750mg PO TDS, then titrated to effect
- max dose is 3g/day


What precautions/side effects are important to be aware of with methyldopa?

- slow onset of action over 24 hours
- dry mouth
- sedation
- depression
- blurred vision
- anaemia
- interferes with some laboratory tests


What classes of antihypertensives are usually contraindicated in pregnancy?

- ACE inhibitors as they have been associated with third trimester fetal death and neonatal renal failure