A 35-year-old woman has hypertension that is controlled with lisinopril and T2DM that is well controlled with multiple daily injections of aspart and glargine insulin. She wants to get pregnant. On examination, BP 134/86mmkg and other vital signs are normal. Cardiovascular examination is normal as well as the rest of her physical examination. Laboratory studies reveal normal electrolytes, renal function, and HbA1c 6.5%. In addition to starting prenatal folic acid, which of the following medication adjustments should be made before she gets pregnant?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة: B. Substitute labetalol for lisinopril
Lisinopril (ACEi) is teratogenic, so before conception it should be replaced by labetalol, a pregnancy-safe antihypertensive (others: methyldopa, nifedipine, hydralazine). Simply stopping it leaves her hypertension untreated; losartan (ARB) is also teratogenic; spironolactone is not a pregnancy-safe choice.
ليش كل خيار صح أو غلط
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A
ليش غلط
Lisinopril has to come off because ACE-I are teratogenic, but simply stopping it leaves her BP untreated; the notes list safe replacements (hydralazine, methyldopa, labetalol, nifedipine).
✓ (Y4)-(M B) Hypertension.pdf · p. 14 -
B
ليش صح
Labetalol (a beta and alpha blocker) is one of the drugs safe and indicated for hypertension in pregnancy.
✓ (Y4)-(M B) Hypertension.pdf · p. 14 -
C
ليش غلط
Losartan is an ARB, and ACE-I and ARBs are listed as unsafe in pregnancy because they are teratogenic.
✓ (Y4)-(M B) Hypertension.pdf · p. 14 -
D
ليش غلط
Spironolactone is not among the drugs listed as safe or indicated in pregnancy (hydralazine, methyldopa, labetalol, nifedipine).
✓ (Y4)-(M B) Hypertension.pdf · p. 14
- المصدر
- (Y4)-(M B) Hypertension.pdf · p. 14
CARDIOLOGY-HTN.pdf · p. 12 - المحاضرة
- Hypertension · Cardiology · Module B
- ظهر في
- Cardio bank