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Reproduction Week 5 2018/19 > 3: Prescribing in pregnancy > Flashcards

3: Prescribing in pregnancy Flashcards

1
Q

Which anti-emetic drug, given in the 1960s, causes birth defects?

A

Thalidomide

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2
Q

What is the rate of miscarriage in the general population?

A

25% of women will have a miscarriage during their lifetimes

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3
Q

Should pregnant woman not take any drugs?

A

Need to weigh benefits vs risks

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4
Q

What alternative therapies could you consider instead of prescribing a drug for a pregnant woman?

A

Physiotherapy

CBT

etc.

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5
Q

Most drugs (are / aren’t) licensed for use in pregnant women.

A

aren’t licensed

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6
Q

What are the principles of prescribing in pregnancy?

A

Benefit > Risk

Low dose monotherapy

Consider interactions

Consider breastfeeding

Avoid high risk drugs e.g warfarin

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7
Q

Does warfarin cross the placenta?

A

Yes

And it’s teratogenic

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8
Q

Does heparin cross the placenta?

A

No

And it isn’t teratogenic

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9
Q

What common condition in pregnancy may affect the absorption of a drug?

A

Morning sickness

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10
Q

Women tend to (gain / lose) weight during pregnancy.

A

gain weight

affecting the drug’s volume of distribution

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11
Q

What doses of folic acid are given to

a) low risk
b) high risk

women before and during pregnancy?

A

a) 400 micrograms
b) 5 milligrams

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12
Q

Which cholesterol-lowering drugs cause birth defects?

A

Statins

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13
Q

What are some examples of chronic conditions which women may have before pregnancy?

A

Asthma

Epilepsy

Cardiovascular disease (e.g high cholesterol, HTN)

Diabetes

Rheumatoid arthritis

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14
Q

During which period is a foetus at greatest risk of harm from drugs?

A

1st trimester

0 - 12 weeks

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15
Q

At which point in gestation do women usually realise they’re pregnant?

A

4 weeks

i.e they’ve been taking the teratogenic drug(s) without knowing they’re pregnant

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16
Q

Which teratogenic drugs are used in hypertension and cause renal hypoplasia?

A

ACE inhibitors

ARBs

17
Q

Which drug, used in RA, causes birth defects?

A

Methotrexate

18
Q

Which drugs, used in severe acne, cause birth defects?

A

Retinoids

19
Q

Which drugs cause respiratory depression and sedation in newborns?

Why might they be prescribed?

A

Opioids

Maternal pain relief

20
Q

Apart from respiratory depression, what might be seen in newborn babies whose mothers have been taking opioids?

A

Withdrawal

21
Q

Pregnancy and its associated symptoms can lower the ___ ___ in epilepsy.

A

seizure threshold

22
Q

Which anti-epileptic drugs should be avoided in pregnancy?

A

Sodium valproate

Phenytoin - terminates status epilepticus

23
Q

What dose of folic acid should a woman with epilepsy receive during pregnancy?

Why?

A

5 milligrams

All anti-epileptic drugs have possibility of causing neural tube defects

24
Q

What percentage of women on anti-epileptics don’t suffer foetal abnormalities?

A

96%

25
Q

___ control of diabetes may cause birth defects.

A

Poor control

26
Q

Which drug used in diabetes is contraindicated in pregnancy?

A

Sulphonylureas

so gliclazide

27
Q

Which drugs, used in adult hypertension, should be avoided in pregnancy?

A

ACE inhibitors

ARBs

28
Q

Which drugs are used to treat pregnancy-induced hypertension?

A

Methyldopa

Labetalol

Nifedipine

29
Q

ACEIs and ARBs cause what kind of birth defect?

A

Renal hypoplasia / absence

30
Q

Which anti-emetic is given first line for morning sickness?

A

Cyclizine

31
Q

How is VTE prevented in pregnant women?

A

Stay mobile

Stay hydrated

If fulfilling risk factors: LMWH e.g dalteparin +/- low dose aspirin

32
Q

Which anticoagulant drug is contraindicated in pregnancy?

A

Warfarin

33
Q

Which anticoagulant drug should be used instead of warfarin in pregnancy?

A

LMWH e.g dalteparin

34
Q

Which antibiotic stains the teeth of young children?

A

Tetracycline

35
Q

Which anti-epileptic drug causes cleft lip and palate?

A

Phenytoin

36
Q

Which anti-epileptic drug is highly associated with spina bifida and anencephaly?

A

Sodium valproate

37
Q

What are some examples of cytotoxic drugs used to treat rheumatic diseases?

A

Azathioprine

Cyclophosphamide

Methotrexate

they’re all teratogenic

38
Q

Which mood stabiliser is teratogenic?

A

Lithium

Reproduction Week 5 2018/19 (9 decks)

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