Pregnancy HTN
Guide use of BP meds during pregnancy
As a cardiovascular pharmacist, more questions arise about managing chronic hypertension in pregnancy due to increasing maternal age, obesity, etc. We know to treat all pregnant patients with severe hypertension 160/110 mm Hg or above. But treatment of nonsevere chronic hypertension, such as 140/90 or more, hasn’t been clear-cut, due to limited evidence. …
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Pregnancy HTN
Be ready to manage SEVERE gestational hypertension
As a clinical pharmacist, you will see more emphasis on urgent treatment of women hospitalized with SEVERE gestational hypertension . Women with gestational hypertension have normal blood pressure (BP) before pregnancy, and develop BPs of at least 140/90 mmHg after 20 weeks' gestation. It's severe when acute-onset BPs reach 160/110 mmHg or higher. …
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Pregnancy HTN
Avoid ACE inhibitors in PREGNANT women
As a clinical pharmacist, you will be asked more, which blood pressure medications are safe to use during pregnancy? ✅ We avoid ACE inhibitors and ARBs because they can cause serious fetal injury or death when used during the second or third trimester. But their effects in the first trimester are more controversial. Some evidence links ACEI …
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Pregnancy HTN
Evaluate blood pressure during pregnancy
Questions will come up about managing gestational hypertension. These women with normal blood pressure before pregnancy who develop blood pressures of 140/90 mmHg or higher AFTER 20 weeks' gestation are at increased risk of premature birth, low birth weight, and infant or maternal death. We know to monitor for progression to preeclampsia ( hypertension over 140/…
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Pregnancy and Breastfeeding
Oral antibiotics that should be used or avoided during pregnancy
Which oral antibiotics are okay during pregnancy? ― Many commonly used antibiotics are safe. But some should be avoided, and many have special precautions. Penicillins, cephalosporins, and clindamycin are generally safe. Metronidazole (Flagyl). Labeling discourages its use in pregnancy due to concerns about fetal malformations. But …
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Pregnancy HTN
Which anti-hypertensives are safe to use during pregnancy?
Uncomplicated hypertension usually isn't treated during pregnancy unless systolic blood pressure is over 160 or diastolic is over 100. Some anti-hypertensives are safer than others during pregnancy ... Labetalol is a good first-line option, either orally or IV. It is both an alpha- and beta-blocker, so it doesn't decrease fetal blood …
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