43. Licit and illicit drug use in pregnancy

Question 1

alcohol in pregnancy causes?

Answer 1

Fetal alcohol syndrome → microcephaly, facial abnormalities, ASD, VSD, brain damage, growth retardation.

Question 2

alkylating agents in pregnancy causes?

Answer 2

Absence of digits, limb abnormalities, fetal death, cleft palate, microphthalmia

Question 3

isotretinoin in pregnancy causes?

Answer 3

Multiple severe birth defects (CNS, CV, craniofacial).

Question 4

cocaine in pregnancy causes?

Answer 4

Low birth weight, preterm birth, placental abruption

Question 5

tobacco smoking in pregnancy interferes with?

Answer 5

prenatal growth (birth weight, birth length, head circumference).

Question 6

valproate or carbamazepine in pregnancy causes?

Answer 6

Neural tube defects

Question 7

what type of effects can Drugs/substances have?

Answer 7

1. direct effects on the fetus (crossing the placenta inducing fetal compromise)
2. indirect effects (vasoconstriction of placental vessels, uterine hypertonia/hypotonia, maternal hypotension, maternal hypoxia).

Question 8

phenytoin in pregnancy causes?

Answer 8

Craniofacial defects (cleft lip, cleft palate); fetal hydantoin syndrome.

Question 9

statins in pregnancy causes?

Answer 9

Increased risk of miscarriage, skeletal malformations.

Question 10

HTN Drugs of choice during pregnancy

Answer 10

• Hydralazine (short-term)
• Labetalol (short-term)
• α-methyldopa (long-term)
• Nifedipine (long-term)

Question 11

CHF Drugs of choice during pregnancy

Answer 11

• β-blockers
• Vasodilators
• Digoxin

Question 12

DM Drugs of choice during pregnancy

Answer 12

• Injectable insulin
• Metformin, glyburide (not in EU)

Question 13

Anticoagulation Drugs of choice during pregnancy

Answer 13

• Unfractionated heparin
• LMWH (enoxaparin, dalteparin)

Question 14

thyroid Drugs of choice during pregnancy

Answer 14

PTU (until 16 weeks gestation)
Methimazole (from 16 weeks onwards)

Question 15

antibiotics used during pregnancy

Answer 15

• Penicillins
• Cephalosporins
• Erythromycin
• Clindamycin

Question 16

psychiatric Drugs of choice during pregnancy

Answer 16

-Antidepressant → fluoxetine
-Antipsychotic → olanzapine, risperidone,quetiapine
-ECT is also considered safe (for multiple indications)

Question 17

simple analgesia used during pregnancy

Answer 17

• Caffeine
• Paracetamol
• Metamizole
• Aminophenazone

Question 18

Anticonvulsants used during pregnancy

Answer 18

• Levetiracetam
• Lamotrigine
• Lacosamide

everything in L!