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PHA332 > Drugs in Pregnancy > Flashcards

Drugs in Pregnancy Flashcards

1
Q

What pregnancy chances occur?

A
  • Increased total body water
  • Increased liver metabolism
  • Inreased renal BF
  • Increased plasma protein conc
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2
Q

What are teratogens?

A

Administration of a drug that can cause structural or functional abnormalities in the foetus or child after birth

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3
Q

What to consider when prescribing in pregnancy?

A
  • Only prescribe if medication benefit outweighs the risk
  • Use drugs with extensive use rather than new
  • Use lowest effective dose
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4
Q

What drugs should not be used in pregnancy?

A

Valproate

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5
Q

What methods of contraception should be used?

A
  • Long-acting reversible contraception (LARC)
  • Copper intra-uterine device
  • Progesterone-only implant
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6
Q

How to advise when preparing for pregnancy?

A
  • Healthy eating, ideal weight, supplements (folic acid), smoking cessation, alcohol consumption, drug misuse, existing medical conditions, vaccinations, cervical & STI screening
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7
Q

What should be avoided in pregnancy?

A
  • Vitamin A supplements and food high in vitamin A
  • Unpasteurised milk and cheese
  • Ripened soft cheese
  • Raw/partially cooked eggs
  • Caffeine
  • Certain seafood
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8
Q

What should the aim for BMI be?

A

Between 18.5 and 24.9 (overweight BMI > 25, obese >30)
No dieting in pregnancy

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9
Q

What dose of folic acid should be taken?

A

Folic acid 400mcg daily, 5mg if high risk
Vitamin D (10mcg)

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10
Q

What should be prescribed if smoking cessation required?

A

NRT
DO NOT prescribe bupropion/varenicline

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11
Q

What is the difference for alcohol consumption accoring to NICE and DoH?

A

NICE: do not drink at all in the first 3 months, increased risk of miscarriage
DoH: Avoid alcohol

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12
Q

Can methadone be taken during pregnancy?

A

Yes, neonatal withdrawal syndrome after

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13
Q

What vaccinations are required for pregnancy?

A
  • Ensure up to date with rubella
  • Tdap (between 27-36 weeks)
  • Influenza
  • COVID-19
  • Others: travel vaccines, Hep A, Hep B, meningococcal
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14
Q

What dose of folic acid should diabetic patients take?

A

5mg

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15
Q

What type of drugs are used to treat diabetes in pregnancy?

A
  • Metformin, glibenclamide
  • Insulin (rapid-acting or isophane NPH insulin)
  • Insufficient evidence for long-acting
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16
Q

What is the target BP for HPT in pregnancy?

A

<135/85mmHg

17
Q

What are the drug options for HPT in pregnancy?

A

Labetalol, nifedipine, methyldopa

18
Q

What is the target BP for postnatal care?

A

<140/90mmHg

19
Q

What are the risk factors for gestational diabetes?

A
  • BMI > 30kg/m2
  • Previous gestational diabetes
  • Family history of diabetes (1st degree relative)
  • Family origin
20
Q

How is gestational diabetes diagnosed?

A

Routine screening

Risk assessment done at first midwife appt and if 1 or more risk factors glucose tolerance test offered between 24-28 weeks (women need to fast 8-10 hours before), given 75g of glucose drink, bloods checked 2 hours after

21
Q

What are the signs/symptoms of gestational diabetes?

A
  • Increased thirst, urinary frequency, dry mouth & tiredness (some women have none)
22
Q

What are the complications of gestational diabetes?

A
  • Larger than usual baby
  • Premature birth (<37 weeks)
  • Pre-eclampsia
  • Complications with the baby
  • Still birth
23
Q

How long after birth are bloods checked?

A

6-13 weeks

24
Q

What is the stages of gestational HPT?

A
  • Hypertension (140/90-159/109mmHg) > labetalol to treat (aim for 135/85mmHg, measure BP once-twice/week)
  • Severe (>160/100mmHg) > admit to hosp, aim for 135/85 measure every 15-30 mins till less than this
25
Q

What is pre-eclampsia?

A

Rapidly progressive condition characterised by high BP and proteinuria

26
Q

What drug is used to treat pre-eclampsia?

A

At high risk - aspirin 150mg daily from 12 weeks until birth

27
Q

What is anaemia and what are the signs/symptoms?

A

Haemoglobin in your blood is lower than normal

  • SOB, poor concentration, poor appetite, muscle weakness
28
Q

When to treat anaemia and with what drug?

A

When Hb is <11g/dl at booking and <10.5g/dl at 28 weeks

  • Ferrous sulphate 200mg TDS or in some cases IV (Ferinject)
29
Q

What is the treatment for VTE?

A
  • LMWH (tinzaparin, dalteparin, enoxaparin)
  • Use booking weight to determine dose
  • Do not use warfarin/DOACs
30
Q

What is a side effect of warfarin in pregnancy?

A

Foetal warfarin syndrom (nasal hypoplasia - airways obstruction & other abnormalities)

31
Q

Which trimester(s) is warfarin most dangerous in?

A

2nd & 3rd trimester (risk of foetal & neonatal haemorrhage)

32
Q

What is the risk of using DOACs?

A
  • Increased miscarriage rates
  • Possible association with foetal abnormalities

PHA332 (14 decks)

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