Is this regimen problematic for your current patient?

A 33-year-old female is brought into the ER where you work. She is 14 weeks pregnant with a BP of 166/111 and severe renal impairment (GFR less than 10mL/min). She also has breathing difficulties and a history of severe asthma attacks when she was younger.
A decision is made to treat the hypertension (HTN) since the risks for the fetus are high anyway. Due to the severe nature of the HTN and her overall condition, a combination regimen is recommended and you are tasked to assist a young physician in assembling the best regimen for this patient out of 3 proposed options.

Question 1

 

First, guidelines suggest which of the following strategies for combination therapy?

Question 1 options:

	Start with high dose of no more than two drugs
	Use drugs from same class
	Use drugs from different classes
	Give each drug seperatey

Question 2

 

Regimen option #1: Captopril + Verapamil. Is this regimen problematic for your current patient?

Question 2 options:

	Yes, Verapamil should be avoided for this patient
	No, this regimen is appropriate for this patient
	Yes, both Captopril and Verapamil should be avoided for this patient
	Yes, Captopril should be avoided for this patient

Question 3

 

Regimen option #2: Metoprolol + Nifedipine. Is this regimen problematic for your current patient?

Question 3 options:

	Yes, Nifedipine should be avoided for this patient
	Yes, Metoprolol should be avoided for this patient
	Yes, both Metoprolol + Nifedipine should be avoided for this patient
	No, this regimen is appropriate for this patient

Question 4

 

Regimen option #3: Hydrochlorothiazide + Propranolol. Is this regimen problematic for your current patient?

Question 4 options:

	Yes, both Hydrochlorthiazide and Propranolol should be avoided for this patient
	Yes, Hydrochlorothiazide should be avoided for this patient
	Yes, Propranolol should be avoided for this patient
	No, this regimen is appropriate for this patient