The Correct Answer is B!
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A 37-year-old woman with a past medical history of hypertension and intermittent asthma presents to clinic for preconception counseling. She would like to become pregnant and has already stopped using contraception. Her medications currently include lisinopril 20 mg daily, hydrochlorothiazide 25 mg daily, and an albuterol inhaler as needed. On examination, her blood pressure is 138/85 mmHg. She took both of her anti-hypertensives this morning. Her cardiovascular examination is unremarkable. Her most recent laboratory work shows normal electrolytes and creatinine of 1.1 mg/dL.
Which of the following is the most appropriate recommendation regarding her anti-hypertension medications in anticipation of pregnancy?
- Stop hydrochlorothiazide and start methyldopa
- Discontinue lisinopril and begin methyldopa
- Increase her levothyroxine
- Add methyldopa to her regimen for gal BP < 140/90 mm Hg
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1. Source: "Comparative Analysis of Pre/Post Assessments of Live/Didactic Course Attendees when compared to Mico-Learning/Online Course Users., "Knowledge to Practice, 2017.