A 30-year-old woman in her 29th week of gestation was found to have a positive direct Coombs' test during a routine prenatal visit. Two months after she became pregnant, she was diagnosed with stage 1 hypertension and started an antihypertensive therapy. Which of the following drugs was she most likely taking?Question 5Answera.Captoprilb.Prazosinc.Nifedipined.Propranolole.Losartanf.Methyldopa
Question
A 30-year-old woman in her 29th week of gestation was found to have a positive direct Coombs' test during a routine prenatal visit. Two months after she became pregnant, she was diagnosed with stage 1 hypertension and started an antihypertensive therapy. Which of the following drugs was she most likely taking?Question 5Answera.Captoprilb.Prazosinc.Nifedipined.Propranolole.Losartanf.Methyldopa
Solution
Para responder a esta pregunta, es importante considerar los efectos secundarios de los medicamentos antihipertensivos y su seguridad durante el embarazo. El test de Coombs directo positivo indica la presencia de anticuerpos que atacan a los glóbulos rojos, lo cual puede ser inducido por ciertos medicamentos.
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Captopril: Es un inhibidor de la enzima convertidora de angiotensina (IECA). Los IECA están contraindicados durante el embarazo debido a sus efectos teratogénicos y potenciales daños al feto.
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Prazosin: Es un bloqueador alfa-adrenérgico. No es comúnmente asociado con un test de Coombs positivo.
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Nifedipina: Es un bloqueador de los canales de calcio. No se asocia con un test de Coombs positivo y es relativamente seguro durante el embarazo.
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Propranolol: Es un beta-bloqueador. No se asocia con un test de Coombs positivo.
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Losartan: Es un antagonista de los receptores de angiotensina II (ARA II). Similar a los IECA, los ARA II están contraindicados durante el embarazo debido a sus efectos adversos sobre el feto.
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Methyldopa: Es un agonista alfa-2 adrenérgico. Es conocido por ser seguro durante el embarazo y es uno de los medicamentos de elección para tratar la hipertensión en mujeres embarazadas. Sin embargo, uno de sus efectos secundarios es la posibilidad de inducir un test de Coombs positivo.
Dado que la paciente está embarazada y se le diagnosticó hipertensión, el medicamento más probable que esté tomando es Methyldopa (f). Este medicamento es seguro durante el embarazo y puede causar un test de Coombs positivo.
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