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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.
(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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