Methyldopa is the preferred first-line oral antihypertensive for chronic hypertension in pregnancy. Which mechanism best explains its safety and efficacy in this setting?
- A Central alpha-2 agonist reducing sympathetic outflow without reducing uteroplacental blood flow ✓
- B Angiotensin-converting enzyme inhibitor preventing vasoconstriction
- C Calcium channel blocker relaxing vascular smooth muscle
- D Thiazide diuretic reducing plasma volume
Correct answer: A. Central alpha-2 agonist reducing sympathetic outflow without reducing uteroplacental blood flow
Explanation
Methyldopa is a central alpha-2 agonist that decreases sympathetic outflow to the heart and vasculature. It effectively lowers blood pressure without compromising uteroplacental blood flow, making it safe for long-term use in pregnancy. ACE inhibitors are strictly contraindicated due to fetotoxicity.
Reference: Katzung Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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