The additional subjective data that is needed from this client is the test for a lipid profile to assess her hypertensive condition. These tests are carried out to assess cholesterol levels in a patient and the risk of developing cardiovascular disease to monitor treatment. Prinzide is a drug used to treat hypertension. It belongs to a group of drugs known as angiotensin-converting enzyme (ACE) inhibitors. Prinzide is not safe for pregnant women because it can cause fetal death or morbidity (Siu, 2015).
Laboratory tests for hypertension are carried out to enable the physician to choose the right lifestyle changes and medicines for the patient to lower his or her blood pressure (Siu, 2015). The results from the laboratory tests provide an important baseline for a person’s blood pressure, which can be used to determine if they are in danger of developing high blood pressure or other cardiovascular diseases.
Since Prinizide is not safe during pregnancy, I would make changes to Ms. BD’s blood pressure medication and prescribe Methyldopa, which does not have side effects on the fetus and the mother. The National Hypertension Society of America recommends long-acting Methyldopa as the acceptable antihypertensive drug therapy for pregnant women with hypertension (Hoeltzenbein et al. 2017). Methyldopa is a competitive inhibitor of the enzyme DOPA decarboxylase, which results in reduced adrenergic and dopaminergic neurotransmission in the peripheral nervous system. It is metabolized to methyl-norepinephrine.
Methyldopa can be administered through the oral route or intravenous route. The half-life of Methyldopa is 105 minutes, and it is completely excreted 36 hours after oral administration. It is largely excreted by the kidney, and individuals with renal dysfunction may respond to smaller cases. The contraindications associated with Methyldopa include slow heart rate, feeling of short breath, jaundice, allergic reaction, and muscle weakness. In pregnant women, prolonged use of Methyldopa can lead to reduced head circumference (Hoeltzenbein et al. 2017). I would treat these patients using Methyldopa.
References
Hoeltzenbein, M. et al. (2017). OP 27 Methyldopa during the first trimester and pregnancy outcome–A prospective observational cohort study. Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health, 9, 21.
Siu, A. L. (2015). Screening for high blood pressure in adults: US Preventive Services Task Force recommendation statement. Annals of Internal Medicine, 163(10), 778-786.
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