Drug use in pregnancy Flashcards
pregnancy category A
controlled studies in animals and women show no risk in the 1st trimester to the fetus
pregnancy category B
- animal studies have show an adverse effect but not confirmed w/ studies done on women in the 1st trimster
- OR animal studies have not shown an effect on risk but no controlled trial on wome
pregnancy category C
- human /animal studies not available
2. animal studies shown harm but no studies done on humans
pregnacncy category D
positive evidene of fetal risk available. Benefits> risk if it is a life threatening disease
pregnancy category X
fetal abnormalities in humans or animals. Use is contraindicated
what does hCG + mean?
it means that the patient is pregnant
five of the top known teratogens (not comprehensive list)
alcohol ACE/ARBS NSAIDS Warfarin Statins SWAN
what vitamins should a women who might get pregnant be on?
folic acid 400-800mcg/day a
calcium 1000mg daily
and vitamine D 600IU diaily
natural sources of folic acid
some fortifiied cereals
dried beans
leafy green vegetables
orange juice
pregnancy and N ausea, Vomiting? TX non pharm
- smaller more requent meals
- avoid spicy or smelly foods
- reducing stress
- take more naps
pregnancy and N ausea, Vomiting? TX pharm
pyridoxime +/- doxyalamine
pregnancy and GERD/Heartburn/Gas pain? TX non pharm
- small more frequent meals
- avoid foods that make gerd arose
- if when sleeping, elevated head of bed
- do not eat > 3 ours before sleeping
pregnancy and GERD/Heartburn/gas pain? TX pharm
first line antacids: calcium carbonate.
H2RAs : caegory B :pepcid, tagament axid, zantac,
PPIs: cagetory B / C
pregnancy and gas? TX pharm
simethicone is safe
pregnancy and constipation? TX non pharm
drink more fluid
indrease fiber
increase walking
pregnancy and constipation ? TX pharm
fiber is firts line
Psyllium is category B
pregnancy and cold flu allegies? TX pharm
- doxylamine first line
- diphenhydramine is cageogry B
- pseudoephdrine, phenyleprhine, oxymetazoline, dextromethorphan, guaifensie are category C
pregnancy and Pain? TX pharm
APAP
can pregant patients get vaccines?
yes, but as long as they are not live vaccines
are antibiotics safe in pregnancy?
yes as long as thye are not fluoroquinolones aor tetracyclines , SMx/TMP avoid in third trimester
UTI and pregnancy tx
beta lactams OK
NItrofurantoin 100mg po bid, except in last weeks of pregnancy
fosfomycin 3g x 1
chlamydia and pregnancy
azithromycin 1g x 1
or amox 500mg po tid x 7 days
gonorrhea and pregnancy
cephalosporin
or azithromycin 2g x 1
pregnancy and bacterial vaginosis
300mg po bid x 7 days
metronidazole 500mg bid or 250mg tid x 7 days
NOT TOPICALS!
vagina trichomoniaisis and pregnacy
2g mentronidazole x 1
250 tid x 7 days
500mg bid x 7 days
asthma and pregnancy
inhaled coricosteroid long term (budesonide preferred)
-albuterol rescue therap
