Drugs in pregnancy: hypertensive emergency: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Drugs in pregnancy: hypertensive emergency

Sample item

A 30-year-old woman at 34 weeks of gestation has a blood pressure of 170/112 mmHg, headache and proteinuria. Which is an appropriate drug for rapid control?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Intravenous labetalol

Severe hypertension in pre-eclampsia is treated promptly with intravenous labetalol, oral nifedipine or intravenous hydralazine. ACE inhibitors are fetotoxic, and nitroprusside is reserved for refractory cases because of fetal cyanide toxicity. Atenolol is associated with fetal growth restriction.

Option by option

  • A. Intravenous sodium nitroprusside as first line

    Nitroprusside risks fetal cyanide toxicity and is not first line.

  • B. Oral atenolol

    Atenolol is associated with fetal growth restriction and is not suited to rapid control.

  • C. Intravenous labetalol (correct)

    Correct. Labetalol is a safe, effective first-line agent in pregnancy.

  • D. Oral enalapril

    Enalapril causes fetal renal failure and oligohydramnios.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is C, Intravenous labetalol. Severe hypertension in pre-eclampsia is treated promptly with intravenous labetalol, oral nifedipine or intravenous hydralazine.

Why is "Intravenous sodium nitroprusside as first line" not the answer?

Nitroprusside risks fetal cyanide toxicity and is not first line.

Why is "Oral atenolol" not the answer?

Atenolol is associated with fetal growth restriction and is not suited to rapid control.

Why is "Oral enalapril" not the answer?

Enalapril causes fetal renal failure and oligohydramnios.

What concept does this question test?

It tests Drugs in pregnancy: hypertensive emergency in Pharmacology. ACE inhibitors are fetotoxic, and nitroprusside is reserved for refractory cases because of fetal cyanide toxicity. Atenolol is associated with fetal growth restriction.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Drugs in pregnancy: hypertensive emergency?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.