Question

A woman who is 32 weeks pregnant has developed significant hypertension which must be treated. What medication options does the Nurse Practitioner have and why? What medications cannot be used in this situation and why?

Answer 1

The medication treatment for the development of hypertension during the pregnancy include

- Beta-blocker: It is the first-line medication for hypertension during pregnancy and lactation. Labetalol is the common drug used. But Atenolol should be avoided for the hypertension pregnant patient.

- Alpha methyldopa: It is most safeness drug used to treat gestational hypertension. It does not affect the features. It can be given as 0.5 to 3.0 g per day with 2- 4 divided doses.

- Calcium channel blocker: Calcium channel blocker can be given for gestational hypertension, In this both Dihydropyridines and non- Dihydropyridines can be used.

- Magnesium sulphate can be given intravenously if the patient develops seizure due to high blood pressure.

The drugs that can be avoided are

- Atenolol: It is a beta-blocker but it is not recommended to use it because of higher chances to developed fetal bradycardia and intrauterine growth retardation.

- Diuretics: These drugs are not given for the hypertension during pregnancy because it has a chances of developing oligohydramnios.

- Renin-angiotensin aldosterone inhibitor: This drug is not recommended during second and third trimester. Use of these drugs leads to fetal malformation like renal dysplasia, pulmonary hypoplasia, growth restriction.