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Teratogenic Medications Pregnancy — ESENeph MCQ

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HardPregnancy & RenalTeratogenic Medications PregnancyESENeph

A 26-year-old woman at 10 weeks gestation has CKD G3b from reflux nephropathy. Her current medications are Ramipril 5 mg and Atorvastatin 20 mg. Both must be changed. What should replace these?

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Correct answer: D — Labetalol and stop Atorvastatin (statins contraindicated in pregnancy)

ACE inhibitors, ARBs, and statins are all contraindicated in pregnancy. Ramipril must be switched to a pregnancy-safe antihypertensive (Labetalol first-line per NICE NG133). Atorvastatin and all statins are teratogenic and must be stopped immediately. They should not be replaced with another lipid-lowering agent during pregnancy. Ideally, these medications should have been changed pre-conception.

Reference: NICE NG133 2019 – Hypertension in Pregnancy; BNF Pregnancy Safety