Drug Use In Pregnancy

Question 1

What’s pregnancy cat X?

Answer 1

Use in preg is CI!

Avoid at all cost, esp during 1st trimester (organogenesis)

Question 2

What’s pregnancy exposure registries?

Answer 2

Exist for select dx states (cancer, autoimmune, HIV, epilepsy)

Collect health info form women taking various drugs when they are preg and breastfeeding

Question 3

What supplements should a young woman be on?

Answer 3

Folic acid - 400-800 mcg daily (0.4-0.8mg/day)

Calcium - 1000mg daily

Vitamin D - 600 IU daily

Question 4

At what dose is Folic acid rx-only?

Answer 4

1mg and higher at prescription only

Question 5

List common OTC treatable conditions in pregnancy

Answer 5

Nausea/Vomiting

GERD/Heartburn/Gas Pains

Constipation

Cough/Cold/Allegies

Pain

Question 6

Tx of nausea/vomiting associated with pregnancy?

Answer 6

Recommend smaller, more freq meals. Avoid spicy or odorous food

Pyridoxine (Vit B6) may be used

Question 7

Tx of GERD/Heartburn/Gas Pains associated with pregnancy?

Answer 7

smaller, more freq meals. Avoid foods that worsen GERD

1st line- calcium antacids e.g. Calcium carbonate in Tums

Question 8

Tx of Gas pains associated with pregnancy?

Answer 8

Simethicone (Gas-X, Mylicon)

H2 antagonists (Pepcid, Tagamet, Axid, Zantac)

PPIs are preg cat B or C

Question 9

Tx of constipation associated with pregnancy?

Answer 9

Increase fluid intake and diet fiber, and physical activity eg walking

1st line - Fiber and Psyllium (Metamucil) (both 1st lines)

Question 10

Tx of Cold/Cough/Allergies associated with pregnancy?

Answer 10

1st line - 1st gen antihistamines

Drug of choice - Chlorpheniramine
Diphenhydramine

Non-sedating 2nd gen agents
Loratadine and Cetirizine (2nd and 3rd trimester use)

Question 11

What nasal steroids are used for chronic allergy sx in pregnancy?

Answer 11

Budesonide (Rhinocort)

Beclomethasone (Beconase AQ)

Question 12

What decongestants are used in pregnancy?

Answer 12

Pseudoephedrine

Phenyephrine

Oxymetazoline

Avoid these in 1st trimester

Question 13

What’s the pain med drug of choice in pregnancy?

Answer 13

Acetaminophen

Question 14

Is flu vaccine recommended in pregnancy?

Answer 14

Inactivated flu vaccines, recommended in all stages of pregnancy

Question 15

Are live vaccine recommended in pregnancy?

Answer 15

No live vaccines 1 month before and during pregnancy

Question 16

Which antibiotics are considered safe during pregnancy?

Answer 16

Penicillin (including amoxicillin and ampicillin, both B)

Cephalosporin

Erythromycin and Azithromycin ( B)
Clarithromycin (C)

Question 17

Which antibiotics should NOT be used in pregnancy?

Answer 17

Quinolones (due to cartilage damage)

Tetracyclines (due to teeth discoloration)

Question 18

UTI (chlamydia) tx in pregnancy?

Answer 18

Azithromycin 1g x 1

Amoxicillin 500mg PO TID x 7 days

Question 19

UTI (Gonorrhea) tx in pregnancy?

Answer 19

Cephalosporin

OR

Azithromycin 2g PO x 1 (if cephalosporin is contraindicated)

Question 20

UTI (Bacterial Vaginosis) tx in pregnancy?

Answer 20

Clindamycin 300mg PO bid

Or

Metronidazole (500mg PO bid or 250mg PO TID) x 7 days

Question 21

What’s not recommended in UTI (Bacterial Vaginosis) tx in pregnancy?

Answer 21

Topical (Vaginal) therapy

Question 22

UTI (Vaginal Trichomoniasis) tx in pregnancy?

Answer 22

Metronidazole 2gm x 1

Question 23

Asthma tx in pregnancy?

Answer 23

Budesonide - preferred controller

Inhaled Albuterol - preferred rescue

Question 24

Venous Thromboembolism/ Mechanical valves tx in pregnancy?

Answer 24

Heparin (UFH) or LMWH

Question 25

Hypothyroidism in pregnancy?

Answer 25

Levothyroxine

Question 26

Hyperthyroidism in pregnancy?

Answer 26

Mild cases not treated

Question 27

What’s pregnancy cat D?

Answer 27

Positive evidence of fetal risk, but benefits may outweigh the risk of life-threatening or serious d