Which of the following antihypertensive drug is not used in pregnancy?(AIIMS May 2015, 2014)
Correct Answer: Enalapril
Description: Ans. a. Enalapril (Ref: Williams Obstertrics 24/e p1006; Goodman and Gilman 12/e p736; Dutta 7/e p228; Katzung 12/e p299)Enatapril is the antihypertensive drug, which is not used in pregnancy."Angiotensin-Converting Enzyme Inhibitors: These drugs inhibit the conversion of angiotensin-I to the potent vasoconstrictor angiotensin-II. They- can cause severe fetal malformations when given in the second and third trimesters.These include hypocalvaria and renal dysfunction. Some preliminary studies have also suggested teratogenic effects, and because of this, they- are not recommended during pregnancy. Angiotensin-receptor blockers act in a similar manner. Bur. instead of blocking the production of angiotensin-II, they inhibit binding to its receptor. They are presumed to have the same fetal effects as ACE inhibitors and thus are also contraindicated. "--Williams Obstetrics 24/e p1006"ACE inhibitors inhibit the conversion of angiotensin-I to the potent vasoconstrictor angiotensin-II. They can cause severe fetal malformations that include hvpocalvaria when given in the second and third trimesters. Because of this, they are not recommended during pregnancy. Angiotensin-receptor blockers act in a similar manner, but instead of blocking the production of angiotensin-II, they inhibit binding to its receptor. They are presumed to have the same fetal effects as ACE inhibitors and are also contraindicated. "--Goodman and Gilman 12/e p736"ACE inhibitors not only block the conversion of ANG I to ANG II but also inhibit the degradation of other substances, including bradykinin, substance P, and enkephalins. The action of ACE inhibitors to inhibit bradykinin metabolism contributes significantly to their hypotensive action and is apparently responsible for some adverse side effects, including cough and angioedema. These drugs are contraindicated in pregnancy because they cause fetal kidney damage. " --Katzung 12/e p299Antihypertensives to be avoided in Pregnancy (Mnemonic: SAAND)Sodium nitroprussideQACE inhibitorsQARBsQNon-selective beta blockersQDiureticsQ
Category:
Gynaecology & Obstetrics
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now