Drug use in pregnancy and lactation Flashcards
What is the pregnancy ranking?
What are the teratogens?
How do you manage morning sickness in pregnancy?
A-X.
Isotretinoin and topical retinoids, Quinolones and tetracyclines, Warfarin, statins, RAAS inhibitors, Hormones, Dihydroergotamine, ergotamine, Hydroxyurea. Lithium, Methotrexate, Misoprostol, Paroxetine, Weight loss drugs, Valproic acid, Ribavirin, Thalidomide, Topiramate.
Lifestyle first, Pyridoxine(vitamin b6) +/- doxylamine, Ginger.
How do you manage GERD/heartburn?
How do you manage flatulence and constipation?
How do you manage cough,cold,allergies?
Lifestyle first, Calcium carbonate in TUMS.
Simethicone, Lifestyle first, fiber(psyllium, calcium polycarbophil).
1st generation antihistamine(chlorpheniramine), chronic allergy can use budesonide, beclomethasone(b for babies). Avoid liquid formulations that contain alcohol.
How do you manage pain and asthma?
How do you managed hypertension in pregnancy?
How do you manage diabetes in pregnancy?
Acetaminophen first-line, possible link between acetaminophen use during pregnancy and ADHD/autism in the child. Inhaled budesonide, inhaled albuterol. Budesonide is preferred steroid for infants, Respules are used in an nebulizer.
Labetalol, Methyldopa, Nifedipine, CI’d RAAS.
Insulin is preferred.
How do you manage infection?
How do you treat VTE?
How do you treat hypo and hyperthyroidism?
Generally safe are penicillins, cephalosporins, erythromycin and azithromycin. Do not use quinolones and tetracyclines. Topical antifungals, treat bacteriuria no matter what, IgG test, unpasteurized dairy products and cat feces avoid.
LMWH preferred, PCD’s. Warfarin is teratogenic, Oral Xa and direct thrombin inhibitors are not recommended.
Hypo is levothyroxine with a 30-50% dose increase during pregnancy. Hyperthyroidism is propylthiouracil 1st trimester and methimazole remainder of pregnancy. Both drugs are liver damage.
How much vitamin D should babies receive in lactation?
What drugs should specifically be avoided in lactation?
400 IU, 1mg/kg daily of iron during months 4-6.
Codeine and Tramadol, Amphetamines, Ergotamines, Lamotrigine, lithium and statins, Metronidazole. HIV infection it’s not recommended.
