Question:easy
A pregnant mother at 35 weeks of gestation with SLE. Which of the following drugs cannot be used?
A pregnant mother at 35 weeks of gestation with SLE. Which of the following drugs cannot be used?
Show Hint
Which of these is a teratogenic folate antagonist contraindicated in pregnancy?
Updated On: Jun 24, 2026
- Prednisolone
- Methotrexate
- Sulfasalazine
- Hydroxychloroquine
Show Solution
The Correct Option is B
Solution and Explanation
Treating lupus in a woman who is 35 weeks pregnant is fundamentally a question of fetal drug safety. The clear answer is the folate antagonist methotrexate: by blocking dihydrofolate reductase it disrupts the rapid cell division of the developing fetus, acting as a powerful teratogen and abortifacient, and is therefore absolutely barred in pregnancy. The other three drugs are acceptable for keeping lupus under control. Prednisolone is extensively broken down by the placental enzyme 11-beta-hydroxysteroid dehydrogenase before it reaches the fetus, so maternal use is permitted; hydroxychloroquine has a strong safety record and current guidance actually advises continuing it throughout gestation because stopping it risks lupus flares; and sulfasalazine is regarded as compatible with pregnancy provided folate is supplemented. Since only one agent must be avoided, the drug that cannot be used is methotrexate.\[\boxed{\text{Methotrexate}}\]
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