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What is Which of the following antihypertensives is not given in pregnancy? (AllMS May 2015. May 2014) and explain in detail?
Ans. a. Enalapril (Ref: Goodman and Gilman 12/e pe p736)Enalapril is not given in pregnancy."ACE inhibitors inhibit the conversion of angiotensin-I to the potent vasoconstrictor angiotensin-II. They can cause severe fetal malformations that include hypocalvaria when given in the second and third trimesters. Because of this, they are not recommended during pregnancy. Angiotensin-receptor blockers act in a similar manner but instead of blocking the production of angiotensin-II, they inhibit binding to its receptor. They are presumed to have the same fetal effects as ACE inhibitors and are also contraindicated." - Goodman and Gilman 12/e pe p736Antihypertensives to be avoided in Pregnancy (Mnemonic: SAAND)Sodium nitroprussideQACE inhibitorsQARBsQNon-selective beta blockersQDiureticsQ