Which of the following antihypertensive drugs is the FIRST-LINE agent recommended for acute severe hypertension (BP ≥160/110 mmHg) in a pregnant woman with a documented penicillin allergy and no contraindications to oral therapy?
- A Oral nifedipine immediate-release 10 mg ✓
- B Oral methyldopa 500 mg
- C IV enalaprilat 1.25 mg
- D IV nitroprusside infusion
Correct answer: A. Oral nifedipine immediate-release 10 mg
Explanation
Oral immediate-release nifedipine (10 mg, repeat in 20 minutes if needed) is a recommended first-line option for acute severe hypertension in pregnancy per ACOG guidance, with onset in 15–20 minutes. Methyldopa is a maintenance agent, not for acute severe hypertension. ACE inhibitors (enalaprilat) are contraindicated in pregnancy. Nitroprusside carries fetal cyanide toxicity risk and is reserved for refractory cases.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.