Which can be used in pregnancy (AIIMS May 2011)
|C||AT receptor antagonist|
a. In pregnant women, ACE inhibitors taken during the first trimester have been reported to cause major congenital malformations, stillbirths, and neonatal deaths. Commonly reported fetal abnormalities include hypotension, renal dysplasia, anuria/oliguria, oligohydramnios, intrauterine growth retardation, pulmonary hypoplasia, patent ductus arteriosus, and incomplete ossification of the skull
b. Unlike most teratogenic medications, fetal toxicity is much more often associated with angiotensin II receptor antagonist exposure during the second and third trimesters. Instead of affecting organogenesis (during 18–60 days post-conception in humans), the adverse fetal (developmental) effects of angiotensin II receptor antagonists are mediated via their action on the fetal renin–angiotensin system (during the second and third trimesters), and partly due to ischemia from maternal hypotension and compromised fetal-placental blood flow.
c. Commonly reported fetal abnormalities include hypotension, renal dysplasia, anuria/oliguria, oligohydramnios, intrauterine growth retardation, pulmonary hypoplasia
d. Propylthiouracil is the drug of choice for thyrotoxicosis in pregnancy. It is highly protein bound and therefore less amount of drug is transferred across placenta and in milk.
e. With carbimazole and methimazole there is risk of fetal hypothyroidism, aplasia cutis, and fetal agranulocytosis.