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Flashcards in Antihypertensive therapy in pregnancy Deck (9)
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1

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

2

What are the main antihypertensive drugs used in pregnancy?

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

3

What is the definition of hypertension in pregnancy

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

4

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

5

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

6

What is the trade name of methyldopa?

Aldomet or Hydopa

7

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

8

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

9

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