Which of the following medications should be held prior to dialysis?

Holding antihypertensives prior to dialysis is appropriate because dialysis can significantly alter blood pressure and fluid balance in patients. During dialysis, patients often experience shifts in fluid volume and electrolyte levels, which can lead to hypotension or other cardiovascular issues. Administering antihypertensive medications right before the procedure may compound these effects, leading to excessively low blood pressure during and after treatment.

In contrast, other medication classes have different considerations. For instance, anti-seizure medications are often continued to prevent seizure activity in patients at risk for seizures due to electrolyte imbalances or uremic conditions. Insulin may also be administered or adjusted depending on the patient's blood glucose levels and the specific dialysis regimen, particularly since dialysis can remove glucose. Antipsychotic medications are typically not directly impacted by the dialysis process and may not require holding unless specifically indicated by the patient's clinical condition. Therefore, the rationale for withholding antihypertensives primarily hinges on the need to maintain hemodynamic stability during dialysis.