Hypertension in pregnancy - Antihypertensive therapy - part 2

Beta adrenergic blockers:
Second line drugs LBW babies reported with long term use.
Eg.1.Atenolol:
Cardio selective beta 1 blocker.
Long duration of action 50 to  100mgs daily, maximum 200mg

2.Propranolol:
Used as a part of acute management of some cardiac or thyroid diseases in pregnancy.

 3.Labetalol:
Has alpha & beta blocking actions. Oral drug for mild to moderate HTN in doses of 100to 400 mgs twice daily.
And IV labetalol for acute severe HTN.

 Side effects:
Mask the signs of hypoglycemia in insulin treated pts with diabetes. Bradycardia, fatigue, depression, dizziness & nausea.


Calcium channel blockers:
May be used 1st line therapy or in combination.
 Eg.1.Nifedipine:
Generally 5to10mgs capsules or tabs available.
 Dose: 10 to 20mgs 3to4 times/day.
 Extended release preparations with slow onset & prolonged effect also available.
Used once or twice daily.
Maximum dose:120mgs/day.

 2.Amlodipine:
Long acting drug used once or twice daily dosage of 2.5 to 10mgs.

Side effects: headache, dizziness, fatigue, heart burn, possible synergism with MgSO4 may result in hypotension, neuromuscular blockade.


-Hypertension in pregnancy-classification
-Hypertension in pregnancy-gestational hypertension
-Preeclampsia
-Eclampsia, preeclamsia superimposed on chronic hypertension
-Chronic hypertension
-Hypertension in pregnancy-etiology and pathogenesis
-Pathology
-Mild hypertension in pregnancy-prevention and management
-Severe hypertension in pregnancy-management
-Severe preeclampsia in pregnancy-management
-Complications of hypertension
-Antihypertensive therapy- centrally acting drugs
-Antihypertensive therapy-beta blockers, calcium channel blockers
-Antihypertensive therapy-alpha blockers, vasodilator, diuretics, ACE inhibitors
-Acute severe hypertension - treatment
-Eclampsia - signs and symptoms
-Eclampsia - management