Drugs In Pregnancy Flashcards
What is a teratogen?
Something which causes an abnormality within the baby following foetal exposure during pregnancy
When are teratogens most dangerous?
At the start of pregnancy - during embryogenesis and organogenesis.
This is when it is most likely to produce a defect.
What affects can smoking have on a baby?
Low birth weight.
Pre-term birth.
Cerebral Palsy.
Learning difficulties.
What condition can be caused by alcohol in pregnancy?
Foetal alcohol syndrome.
What are the common characteristics of foetal alcohol syndrome?
Facial: smith philtrum, thin vermillion border, small palpebral fissures.
Brain: Microcephaly, seizures, intellectual disability.
Other: Low weight, small height, Limb dislocation, heart defects.
What common symptoms do elicit drugs cause?
Low birth weight.
Withdrawal symptoms.
Learning and behavioural problems.
What is pharmacokinetics?
What the body does to a drug, including absorption, distribution, metabolism and excretion.
What is pharmacodynamics?
What the drug does to the body.
What condition does the consumption of thalidomide during pregnancy cause?
Phocomelia (shortening of the limbs)
What medications are prescribed for nausea and vomiting?
First Line:
Cyclizine (antihistamine)
Prochloroperazine (phenothiazine)
Doxylamine/pyridoxine combination
Second Line:
Ondansetron
Metoclopramide
What medications can be used to treat hypertension in pregnancy?
Start daily aspirin from week 12
Labetelol (beta blocker)
Nifedipine (calcium channel blocker)
Methyldopa (antihypertensive)
Hydralazine (vasodilator)
Which hypertensive medications should be stopped in pregnancy?
ACE inhibitors (end in pril) Angiotensin receptor blockers (end in sartan)
these should be stopped/swapped as soon as pregnancy is confirmed.
Why is folic acid given to mothers during pregnancy?
For neural tube development: to prevent spina bifida and anencephaly.
Which birth defects are increased slightly when taking AED’s (anti epileptic drugs)?
Spina bifida/neural tube defects (sodium valproate) Cleft lip (sodium valproate) Heart abnormalities (phenobarbitone) Brain - reduced memory, attention and speech development.
What amount of folic acid should be given to mothers during pregnancy?
The normal amount is 400mcg daily from 12 weeks.
Who should receive high dose folic acid in pregnancy?
Those with an increased risk of having neural tube defects. Epilepsy previous children with NTD Diabetes Obesity Malabsorption disorders
Which drugs should be used in a diabetic who is pregnant?
All oral anti diabetic drugs should be stopped (except METFORMIN) and substituted with insulin therapy.
Which diabetic drug can be resumed after pregnancy and during breast feeding?
Glibenclamide.
Which drugs should be given to pregnant women with an increase of thromboembolism?
Low molecular weight heparin
WARFARIN IS TERATOGENIC
Which thromboembolic drugs are contraindicated in pregnancy?
Warfarin
DOACs (end in aban)
What are common abnormalities seen if warfarin is used during pregnancy?
Nasal hypoplasia
Skeletal abnormalities - short limbs and digits
Stippled epiphyses
WARFARIN CAN BE USED DURING BREAST FEEDING.
Which medication can be used to treat asthma in pregnancy?
Beta 2 agonist - albuterol, salbutamol
Inhaled corticosteroid - budesonide
systemic corticosteroid - severe asthma
Theophyline (can cause potential toxicity)
What medications can be used to treat headaches and migraines?
Parcetamol
Ibuprofen - AVOID In 3rd trimester
Sumatriptan - acute migraine
Propanolol
What are the potential complications of antidepressants and antipsychotics?
Lithium - cardiac anomaly
Diazepam - cleft lip, floppy infant syndrome
Quetiapine - large baby, poor neonatal adaptation syndrome
Which antibiotics are safe in pregnancy?
Penicilin
Erythromycin
Azithromycin
Cephalospirons
Which antibiotics are contraindicated in pregnancy?
Tetracycline - effects skeletal development
Sulphonamides - teratogenic (avoid in 1st semester)
Aminoglycosides (streptomycin) - auditory or vestibular nerve damage
What cancer treatments can be used in pregnancy?
Should be avoided if possible - most cytotoxic drugs are teratogenic.
