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Hypertension in pregnancy — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsHypertension in pregnancyGPhC CRA

A 31-year-old woman taking ramipril for hypertension tells the pharmacist she has just found out she is pregnant. She has not yet spoken to her GP or midwife. What is the most appropriate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Advise urgent same-day contact with the prescriber to change ramipril

ACE inhibitors should be avoided in pregnancy because of fetal risk, particularly later in pregnancy. The pharmacist should advise urgent prescriber review so treatment can be changed to a suitable option such as labetalol, nifedipine or methyldopa where clinically appropriate. The medicine should not be tapered by the patient without clinical advice. Aspirin is not an antihypertensive replacement.

Reference: BNF; NICE CKS