6. Medications and pregnancy.

Question 1

what is a medication that are the medications that are contraindicated in pregnancy ?

Answer 1

NSAIDS
thalidomidethalidomide , ACE - inhibitors , 
tetracyclin 
 aminoglycosides , 
doxycylin , streptomycin ,androgens ,
 benzothiadizine ,
 coumardin derivative such as warfarin ,
 lithium , 
phenytoin , 
valproic acid ,
vita A , 
methotrexate

Question 2

why are NSAID’s contraindicated

Answer 2

inhibit the synthesis of prostaglandins

prostaglandins are required to keep the ductus arteriosus open - so taking NSAIDS results in premature closure of ductus arteriosus

ductus arteriosus is connection of pulmonary arteries to the aorta - and bypass the lungs - if they do not bypass the lungs the pulmonary capillaries are constricted because there is no oxygen - high Bp if blood tries to flow through them - meaning high work load for the right heart - leading to heart failure

Question 3

what is a tetrogen

Answer 3

anything that causes birth defect to occur higher than normal

can be drug , chemical , infection , radiateon or maternal conditions such as diabetes

Question 4

most tetrogenic effects are seen when ?

Answer 4

in 5th - 10th week organogensisis taking place

Question 5

classification of medication has been introduced according to their possible toxic effects on fetus describe this classification

Answer 5

Class A - adequate / week cantorlled studies in pregnant women showing no harmful effect in any trimesters

Class B - animal studies show no harmful effects / however there are no adeqet and well controlledstudies done on pregnant women or Animal studies show to have a bad effect , however well controlled studies in pregnant women in all trimesters have not

Class C - animal studies shown adverse effects - not been done on pregnant women
no animal studies or pregnant women studies done

Class D - well controlled pregnant women studies on the medicament have shown risk to fetus
however benefits may outweigh the risk - if they are undergoing chemotherapy which is life threatening situation

Class X - well controlled studies in animal and pregnant women have shown there is a positive detrimental effect on fetal abnormalities
product contradicted in women who are or may become pregnant

Question 6

sometimes diseases do occur and safe antibiotics to take are?

Answer 6

penicillin , amoxicillin , ampicillin
cephalosporins
erythromycin
clindamycin

Question 7

Antihypertensive drugs are essential when the BP is 160/110 mm Hg to protect the mother from eclampsia, cerebral hemorrhage, cardiac failure and placental abruption what drugs are given?

Answer 7

First line therapy is either

methyldopa (Sympatho- lytics) or labetalol (andrenergic receptor blocking agents)

Second line drug is nifedipine
Nicardipine

vasodilators
Hydralazine Nitroglycerin Sodium
nitroprusside

ACE very last resort

Question 8

anticonvUlSantS for eclampsia ?

Answer 8

magnesium sulfate

diazepam -Respiratory depressant effect
Hypotonia, thermoregulatory problem in newborn

phenytoin
Fetal hydantoin syndrome (when used in first trimester)

Question 9

Anticoagulants for Cardiac disease, venous thrombosis, antiphospholipid syndrome?

Answer 9

Heparin
 (unfractionated heparin)
 low-molecular- weight heparin (lmWH)
DOES NOT CROSS PLACENTAL BARRIER