Anti-hypertensive agents

Question 1

Treatment of severe hypertension in pregnancy

sBP>160 and dBP >110

Answer 1

1) labetalol 20 mg IV then 20-80 mg IV q 30 min (max 300 mg)
* avoid in asthma or heart failure

2) Nifedipine 5-10 mg PO q 30 min
3) Hydralazine 5 mg IV; repeat -10 mg IV q 30 min

Question 2

Treatment for non-severe hypertension

BP 140-159/90-109

Answer 2

1) methyldopa 250 -500 mg PO BID-QID
2) labetalol 100-400 mg PO BID-QID (max 1200)
3) Nifedipine 20-60 mg PO OD (max 120)

Question 3

Regional anaesthesia can be delivered:

1) at what level of platalets
2) x hrs following therapeutic dose of LMWH
3) x hrs following prophylactic dose of LMWH

Answer 3

1) >75 x 10^9
2) 24 hours following therapeutic dose of LMWH
3) 12 hours following prophylactic dose of LMWH

Question 4

Therapies for HELLP syndrome:

1) what level of plt transfusion
2) what level of plts for vaginal delivery
3) what level of plts recommended prior to C/S

Answer 4

1) < 50 x 10^9, when falling rapidly, and/or coagulopathy
2) <20 x 10^9 for vaginal delivery
3) <20 x 10^9 for C/S