What pregnancy category are alpha-2 agonists included in?

• A. Pregnancy category A
• B. Pregnancy category B
• C. Pregnancy category C
• D. Pregnancy category D

Answer: (B)

The question tests understanding of how pregnancy risk is categorized for drugs used in glaucoma. Alpha-2 adrenergic agonists used topically, like brimonidine and apraclonidine, are classified as pregnancy category B. This means that either animal studies show no fetal harm and there are no well-controlled human studies, or animal studies show some risk but human data do not indicate harm. The practical takeaway is that the fetal risk appears low because these are used as eye drops with relatively limited systemic absorption, but data are not extensive, so they’re used in pregnancy only when the potential benefits outweigh any unknown risks. For context, category A would imply no risk in humans, category C suggests potential risk with unclear human data, category D indicates known fetal risk, and category X is contraindicated in pregnancy.