Which of the following antihypertensives is not given in pregnancy? (AllMS May 2015. May 2014)
## **Core Concept**
The question tests knowledge of antihypertensive drugs safe to use during pregnancy. Pregnancy-induced hypertension is a significant concern, and the choice of antihypertensive medication is crucial to ensure both maternal and fetal safety.
## **Why the Correct Answer is Right**
ACE inhibitors (Angiotensin-Converting Enzyme inhibitors), such as **Captopril** (though sometimes used cautiously), are generally contraindicated in pregnancy, especially in the second and third trimesters, due to the risk of fetal renal damage and other complications. However, among the given options, **Losartan**, an angiotensin II receptor antagonist (ARB), is particularly noted for its potential to cause fetal harm when used during pregnancy, similar to ACE inhibitors but through a different mechanism. It can cause fetal renal damage and is usually avoided.
## **Why Each Wrong Option is Incorrect**
- **Option A:** Methyldopa is commonly used to treat hypertension in pregnancy and is considered relatively safe.
- **Option B:** Labetalol is also frequently used in pregnancy-induced hypertension and is considered safe for both mother and fetus.
- **Option D:** Nifedipine, a calcium channel blocker, can be used in pregnancy but with careful monitoring. It's often used for acute blood pressure control.
## **Clinical Pearl / High-Yield Fact**
A key point to remember is that **ACE inhibitors** and **ARBs (Angiotensin Receptor Blockers)**, like **Losartan**, are generally avoided in pregnancy due to their association with fetal renal damage and other complications. Methyldopa, Labetalol, and Nifedipine are often considered safer options for managing hypertension during pregnancy.
## **Correct Answer:** . Losartan