Drug handling in pregnancy Flashcards
Effects of drugs on pregnancy
Fertilisation and implantation
Organogenesis
Growth and development
Drugs at the end of pregnancy
Teratogenicity
Vitamin A derivatives
Occurs in first three weeks of gestation before pregnancy declares itself
Severe CNS, cardiac and craniofacial abnormalities
Not for women of child bearing age unless they practice effective contraception and have received counselling
Valproate
Use effective contraception during treatment
Other teratogenic drugs
Alcohol
Tetracyclines
Warfarin
Antibiotics
Antithyroid drugs, anticonvulsants, antihypertensives
Lithium
Herbal remedies
Volume of distribution
Increased during pregnancy
May affect the loading dose of drugs
Protein binding
Reduced maternal albumin concentrations
May affect levels of highly protein bound drugs
Drug clearance
Increased renal plasma flow during pregnancy
Safe use of drugs in pregnancy
Avoid drugs if possible
Risk/ benefit
Use drugs of proven safety
Short courses and lower doses
Drugs and breast feeding
Avoid drugs if possible
Risk/ benefit
Feed baby just prior to next dose
Supplement breast milk with formula feeds
