DRUGS IN PREGNANCY

Question 1

what increases the risk of congenital malformations in babies?

Answer 1

if the mother is exposed to drugs, chemicals, radiation, infections, maternal metabolic disorders

Question 2

what makes an agent a teratogen?

Answer 2

something that can cause birth defects or abnormalities in a developing embryo or fetus upon exposure

Question 3

what are some common teratogens?

Answer 3

some medications, recreational drugs, tobacco products, chemicals, alcohol, certain infections, and in some cases, health problems such as uncontrolled diabetes in pregnant people.

Question 4

how much alcohol is needed to cause foetal alcohol syndrome?

Answer 4

more than 13 alcoholic drinks per month of pregnancy or more than 2 alcoholic drinks in one sitting

Question 5

what are the symptoms of foetal alcohol syndrome?

Answer 5

a head thats smaller than average, poor growth, small eyes, thin upper lip, smooth area between nose and upper lip, movement and balance problems, learning difficulties, issues with attention, concentration or hyperactivity, hearing/vision problems

Question 6

what is multifactorial inheritance?

Answer 6

when more than one factor causes a trait or health problem

Question 7

what is the no observable effect level?

Answer 7

The highest dose or exposure level of a substance or material that produces no noticeable toxic effect

Question 8

why is sodium valproate contraindicated in pregnancy?

Answer 8

1/10 babies are at risk of a birth defect

Question 9

when is the period of maximal susceptibility of teratogenic effects?

Answer 9

first 12 weeks (10 weeks post conception)

Question 10

what is anencephaly?

Answer 10

a life limiting condition where the baby’s brain and spinal cord dont develop properly`

Question 11

how do we treat pain in pregnancy?

Answer 11

1- non-pharmacologically if possible

2- paracetamols, codeine, NSAID, cocodamol

3- tramadol

4-opiates

Question 12

how to treat nausea and vomiting in pregnancy?

Answer 12

1- non-pharmacologically with small, high carb, low fat, frequent meals

2- cyclizine or promethazine

3- prochlorperazine or metoclopramide

Question 13

how do you treat constipation during pregnancy

Answer 13

1 - non-pharmacolgocially (increased fibre, fluid and exercise)
bulk forming laxatives
lactulose
glycerin suppositories
bisacodyl
Senna
docussate sodium

Question 14

what’s the order for choosing empirical antibiotics?

Answer 14

penicillins and cephalosporins
erythromycin and clindamycin
nitrofurantoin, trimethoprim and co-trimoxazole
azithromycin, clarithromycin, metronidazole, fusigic acid, ciprofloxacin
quinolines and tetracyclines

Question 15

When would exposure to a teratogen have to happen for a baby to be born with spina bifida or anencephaly?

Answer 15

3,5-4.5 weeks

Question 16

When would exposure to a teratogen have to happen for a baby to be born with limb reduction?

Answer 16

12-40 days

Question 17

When would exposure to a teratogen have to happen for a baby to be born with transposition of the great vessels?

Answer 17

34 days

Question 18

When would exposure to a teratogen have to happen for a baby to be born with cleft lip?

Answer 18

36 days

Question 19

When would exposure to a teratogen have to happen for a baby to be born with ventricular septal defects?

Answer 19

42 days

Question 20

When would exposure to a teratogen have to happen for a baby to be born with hypospadias (when urethra is on underside of penis)?

Answer 20

84 days

Question 21

When would exposure to a teratogen have to happen for a baby to be born with syndactyly (webbed digits)?

Answer 21

42 days

Question 22

what is the possible effect on the foetus if the mother takes androgens?

Answer 22

virilisation (development of male characteristics) of the female foetus

Question 23

what is the possible effect on the foetus if the mother takes oestrogens?

Answer 23

feminisation of the female foetus

Question 24

what is the possible effect on the foetus if the mother takes warfarin?

Answer 24

nasal hypoplasia or skeletal defects

foetal haemorrhage and CNS abnormalities if taken after the 1st trimester

Question 25

what is the possible effect on the foetus if the mother takes retinoids?

Answer 25

craniofacial, cardiovascular and CNS defects

Question 26

what is the possible effect on the foetus if the mother takes diethylstilboestrol?

Answer 26

uterine lesions

Question 27

what is the possible effect on the foetus if the mother takes antiepileptics?

Answer 27

facial defects
mental retardation
autism/asperges (if taken after 1st trimester)
neural tube defects

Question 28

what is the possible effect on the foetus if the mother takes antidepressants after the 1st trimester?

Answer 28

neonatal withdrawal symptoms

Question 29

what is the possible effect on the foetus if the mother takes benzodiazepines after the 1st trimester?

Answer 29

floppy infant syndrome
neonatal respiratory depression
withdrawal symptoms

Question 30

what is the possible effect on the foetus if the mother takes ACE inhibitors after the 1st trimester?

Answer 30

oligohydraminous
frowth retardation
lung and kidney hypoplasua
hypocalvaria
neonatal convulsions
hypotension
anuria

Question 31

why should you not take NSAIDs after week 20 of pregnancy?

Answer 31

may cause rare but serious kidney problems in baby

may cause premature closure of ductus areriosus which can cause hypertension/foetal death