Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

For a pregnant woman with unmanaged coronary artery disease, which drug therapy option is best?

1. Niacin

2. Atorvastatin

3. Gemfibrozil

4. Colesevelam

The correct answer is: Colesevelam

In the context of pregnant women who have unmanaged coronary artery disease, the choice of drug therapy must carefully weigh the benefits for heart health against the safety for the fetus. Colesevelam is a bile acid sequestrant that is considered safe for use during pregnancy and can help lower cholesterol levels without the risks associated with other medications. For instance, atorvastatin and gemfibrozil are both contraindicated during pregnancy because they can negatively affect fetal development. Statins like atorvastatin can lead to serious birth defects and complications. Likewise, gemfibrozil is not recommended because studies have shown it can be harmful to the fetus. Niacin, while occasionally used for lipid management, is also not considered safe or effective during pregnancy and may pose risks. Choosing colesevelam provides a therapeutic option that can help manage lipid levels and provide cardiovascular benefits while minimizing risks to the developing fetus. Therefore, for pregnant women facing coronary artery disease, colesevelam stands out as the best option among the listed choices.