<prompt> The anti-hypertensive agent of choice in pregnancy isLabetalolHydralazineMethyldopaClonidine  <response>: Ans- A Labetalol Old guidelines: Methyl dopa New guidelines: PIH: Oral Labetalol Htn emerg: IV Labetalol HYPERTENSION Definition: Sustained elevation of blood pressure causing cardiovascular mortality. Regulation of BP: 1. Baroreceptors: regulate short term, movement to movement control of Blood pressure 2. RAAS System: Long term maintenance of Blood pressure Types: 1. PRIMARY: idiopathic or Essential hypertension Most common type No identifiable cause, A: associated with high Salt intake Low potassium High NaK ratio Low Mg and Ca B: RAAS activity can be low, normal or high Tt: JNC 8 criteria for HTN 2: SECONDARY: identifiable cause Like phaeochromocytoma, Hyperthyroidism, aortic dissection, Cushing syndrome etc Tt: management of specific cause. Drugs for HTN First line drugs JNC 8 guidelines 1. ACE inhibitors or AT1 receptor blockers ARB: DOC for CKD HTN DOC: HTN Gout Losartan Telmisartan: HTN with DM PPAR-gamma agonist 2. CCB DHP TYPE: Amlodipine, Nifedipine, Nimodipine DOC: SAH, PVD Nicardipine: DOC for HTN emergency 3. THIAZIDES DIURETICS only long acting Second line drugs 4. Beta blockers: Cardioselective : metoprolol, Nebivolol etc...DOC for HTN Angina 5. Alpha blockers: Prazosin etc..DOC for HTN BPH 6. Alpha beta blockers. Labetalol: DOC in Pregnancy 7. Vasodilators Artery: Hydralazine, Minoxidil, Diazoxide Venous: Nitrates Combined: Nitroprusside Fastest acting 8. Potassium sparing diuretics: Spironolactone, Eplerenone DOC: resistant hypertension Others 8. Central sympatholytics alpha 2 agonists: Clonidine, Alpha methyldopa second line in pregnancy 9. Ganglionic Blockers: Trimethaphan Arterial surgeries 10. Dopamine agonist: Fenoldopam 11. Renin inhibitors: Aliskiren 12. Release inhibitors: Guanethidine, Bretylium 13. Loop diuretics: Furosemide etc ...,,,...,,,...,,,...,,,...,,,. JNC-8 guidelines Mnemonic for antihypertensive drugs safe in pregnancy Better mother care during hypertensive pregnancy Better - beta blockerscardioselective and labetalol Mother - methyldopa Care- clonidine During - dihydropyridine calcium channel blockers Hypertensive - hydralazine Pregnancy - prazosin alpha blockers 