Drugs in obstetrics Flashcards
Consequences of teratogens
- Chromosomal abnormalities
- Impaired implantation
- Resorption of early embryo
- Structural malformations
- IUGR
- Foetal death
- Deafness
- Mental retardation
What is a teratogen
Agent which, upong administartion to the pregnant mother, causes structural or functional abnormalities in the foetus or child after birth
What is transplacental carcinogenicity?
Agent that causes cancer in the offspring but not mother e.g. diethylstillboestrel
Diethylstilbestrol (DES) is a synthetic form of the female hormone estrogen. It was prescribed to pregnant women between 1940 and 1971 to prevent miscarriage, premature labor, and related complications of pregnancy
Methotrexate and pregnancy
Recommended that women taking methotrexate stop 6 months before trying for baby
Also applies to male partner
Examples of birth abnormalities that methotrexate may cause include: Neural tube defects that affect the brain, spine, or spinal cord
Methotrexate is used to manage ectopic pregnancies
Exposure to which teratogens would result in the termination or pregnancy being advised?
Warfarin and retinoids (isotretinoin)
Use of analgesia in pregnancy
Paracetamol - ok
NSAIDs not used after 28 weeks due to premature closure of DA
Codeine - ok but causes constipation
Management of nausea and vomiting in pregnancy
Non pharmacological: small high carb low fat meals
Pharmacological: cyclizine/ ptomethazine or ondansetron if treatment resistant
Hyperemesis gravidarum: hospitalisation, fluid and electrolyte replacement, thiamine to prevent Wernicke’s, corticosteroids if severe and need to expedite delivery
Which type of antibiotic should be avoided after 15 weeks in pregnancy?
Quinolones
Fluoroquinolones are to be used with caution in pregnancy. Both ciprofloxacin and levofloxacin have been assigned pregnancy category C by the FDA (foetal risk is not confirmed by human studies but has been shown in some animal studies)
