Drug Use In Pregnancy Flashcards
What’s pregnancy cat X?
Use in preg is CI!
Avoid at all cost, esp during 1st trimester (organogenesis)
What’s pregnancy exposure registries?
Exist for select dx states (cancer, autoimmune, HIV, epilepsy)
Collect health info form women taking various drugs when they are preg and breastfeeding
What supplements should a young woman be on?
Folic acid - 400-800 mcg daily (0.4-0.8mg/day)
Calcium - 1000mg daily
Vitamin D - 600 IU daily
At what dose is Folic acid rx-only?
1mg and higher at prescription only
List common OTC treatable conditions in pregnancy
Nausea/Vomiting
GERD/Heartburn/Gas Pains
Constipation
Cough/Cold/Allegies
Pain
Tx of nausea/vomiting associated with pregnancy?
Recommend smaller, more freq meals. Avoid spicy or odorous food
Pyridoxine (Vit B6) may be used
Tx of GERD/Heartburn/Gas Pains associated with pregnancy?
smaller, more freq meals. Avoid foods that worsen GERD
1st line- calcium antacids e.g. Calcium carbonate in Tums
Tx of Gas pains associated with pregnancy?
Simethicone (Gas-X, Mylicon)
H2 antagonists (Pepcid, Tagamet, Axid, Zantac)
PPIs are preg cat B or C
Tx of constipation associated with pregnancy?
Increase fluid intake and diet fiber, and physical activity eg walking
1st line - Fiber and Psyllium (Metamucil) (both 1st lines)
Tx of Cold/Cough/Allergies associated with pregnancy?
1st line - 1st gen antihistamines
Drug of choice - Chlorpheniramine
Diphenhydramine
Non-sedating 2nd gen agents
Loratadine and Cetirizine (2nd and 3rd trimester use)
What nasal steroids are used for chronic allergy sx in pregnancy?
Budesonide (Rhinocort)
Beclomethasone (Beconase AQ)
What decongestants are used in pregnancy?
Pseudoephedrine
Phenyephrine
Oxymetazoline
Avoid these in 1st trimester
What’s the pain med drug of choice in pregnancy?
Acetaminophen
Is flu vaccine recommended in pregnancy?
Inactivated flu vaccines, recommended in all stages of pregnancy
Are live vaccine recommended in pregnancy?
No live vaccines 1 month before and during pregnancy
Which antibiotics are considered safe during pregnancy?
Penicillin (including amoxicillin and ampicillin, both B)
Cephalosporin
Erythromycin and Azithromycin ( B)
Clarithromycin (C)
Which antibiotics should NOT be used in pregnancy?
Quinolones (due to cartilage damage)
Tetracyclines (due to teeth discoloration)
UTI (chlamydia) tx in pregnancy?
Azithromycin 1g x 1
Amoxicillin 500mg PO TID x 7 days
UTI (Gonorrhea) tx in pregnancy?
Cephalosporin
OR
Azithromycin 2g PO x 1 (if cephalosporin is contraindicated)
UTI (Bacterial Vaginosis) tx in pregnancy?
Clindamycin 300mg PO bid
Or
Metronidazole (500mg PO bid or 250mg PO TID) x 7 days
What’s not recommended in UTI (Bacterial Vaginosis) tx in pregnancy?
Topical (Vaginal) therapy
UTI (Vaginal Trichomoniasis) tx in pregnancy?
Metronidazole 2gm x 1
Asthma tx in pregnancy?
Budesonide - preferred controller
Inhaled Albuterol - preferred rescue
Venous Thromboembolism/ Mechanical valves tx in pregnancy?
Heparin (UFH) or LMWH
