Drug Use in Pregnancy & Lactation Flashcards
what does G2P1
patient has been pregnant twice and given birth once
what supplementation and at what doses are recommend while preg
folate 600mcg/day
calcium 1000mg/day
Vit D 600IU/15mcg a day
what is preg category A
tested in animals and women and deemed safe in first trimester
what is preg category B
animal studies showed no risk but there are no studies in preg women
what is preg category C
animal studies showed harm, but no well controlled studies in humans
what is preg category X
animal and human studies showed fetal abnormalities
contraindicated in pregnancy
what drugs are teratogens
ABX: FQs, TTC, AGs
acne: tretinoins
anticoag: warfarin
HLD/HTN/HF: RAASi, statins
all hormones
amiodarone
Li
VPA
hydroxyurea
MTX
topamax
paxil
misoprostol
benzos
opiates
NSAIDs
preeclampsia definition
HTN with possible end organ damage between 20 weeks gestation and delivery
eclampsia definition
epilepsy between 20 weeks gestation and delivery
why and when should ASA 81mg be initiated during gestation
preeclampsia + DM, kidney disease, hx preeclampsia, chronic HTN
in second and third trimesters
what are the trimesters in pregnancy
First trimester: Weeks 1–12 (3mo)
Second trimester: Weeks 13–28
Third trimester: Weeks 29–40, the shortest trimester
morning sickness/N/V tx in pregnancy
doxylamine and B6 (pyridoxime)
brand = Bonjesta or Diclegis
ginger
GERD/heartburn tx in pregnancy
lifestyle + TUMS first line
H2RA and PPI second line
flatulence tx in pregnancy
simethicone (GasX)
constipation tx in pregnancy
2 = PEG, docusate
lifestyle and inc fiber
cough, cold, allergies tx in pregnancy
cromolyn x 3d
budesonide (Rhinocort)
beclometasone
avoid liquids with alcohol
pain tx in pregnancy
APAP and non-pharm
ASA only ok for preeclampsia
asthma tx in pregnancy
budesonide (Rhinocort) and albuterol
IDA tx in pregnancy
prenatal with iron
HTN tx in pregnancy
labetalol, methyldopa, nifedipine
DM tx in pregnancy
insulin
ABX safe in preg
penicillins
cephalosporins
macrolides
vaginal fungal infxn tx in pregnancy
topical antifungals x 7d
UTI tx in pregnancy
always tx bacteruria even if asx and (-)UA
cephalexin 500mg PO 4x/day x7d
ampicillin 500mg PO 4x/day x7d
SMX and Macrobid are last line in first trimester and last 2 weeks of pregnancy
anticoag tx in pregnancy
LMWH
hypothyroidism tx in pregnancy
levothyroxine, dose may need to be increased 30-50%
hyperthyroidism tx in pregnancy
PTU in first trimester
MMZ in second and third trimesters
which vaccines should pregnant patients receive
inactivated influenza vaccine
TdaP
how much vitamin D do babies receive in breastmilk
10mcg/400IU a day
iron supplementation in newborns
when to supplement, how much to supplement and why do we start at that time
1mg/kg/d in months 4-6
iron stores in newborn can last them for 4 months!
while breastfeeding, how should mom use supplements
inc diet by 450-500kcal/day
continue omega 3 FAs
continue prenatal vitamin
what drug characteristics increase excretion into breastmilk
low Vd
unionized
lipophilic
low MW
what drugs should NOT be taken by the mom while breastfeeding
tramadol
codeine and ANY opiate
tobacco
amiodarone
ergotamines
statins
phenobarb
amphetamines
Li
can a mom breastfeed until suspected HIV results come back negative
no, should not breastfeed if there is even a slight possibility of HIV
