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Hypertension drugs (antihypertensives)

Angiotensen converting enzyme inhibitors have been associated with fetal death in-utero.  They should not be used during pregnancy.  Another antihypertensive drug, diazoxide,  enters the fetal circulation and may cause fetal bradycardia.  Hyperglycaemia has been observed in the newborn.  Diazoxide is a potent relaxant of uterine smooth muscle and may inhibit uterine contractions if taken during labour.  There diazoxide should be used with extreme caution during labour.  The use of another drug, reserpine, near term can result in nasal discharge, lethargy and poor feeding in the newborn.

(i) Beta-blockers - The principle effect of atenolol  as a cardioselective beta-adrenoreceptor blocking agent is to reduce cardiac activity  by diminishing or preventing beta-adrenoreceptor stimulation, thereby reducing the response of the heart to stress and exercise. In angina pectoris, this reduced oxygen consumption and increases exercise tolerance of the heart.
 

Products: Atenolol
For Children: Not recommended
For Pregnant Women: No evidence of risk
For Breastfeeding Mothers: Use with caution
Contra-indications*: Sinus bradycardia
Caution: Hepatic and liver dysfunction

(ii) Calcium channel blockers - In the treatment and prophylaxis of angina pectoris and in hypertension, nifedipine acts by reducing cardiac work and myocardial oxygen and by reducing peripheral resistance and heart load. But pregnant women should not use this drug as it may harm the foetus.
 

(iii) Ace inhibitor - Emalapril is an orally active (antinogen II converting enzyme) ace inhibitor, lowering peripheral vascular resistance without increasing heart rate. It is an ideal anti-hypertensive  for patients intolerant to beta-blockers. It is useful in treating congestive cardiac failure. But pregnant women should not use this drug as it may harm the foetus.


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