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Reproductive System > Drugs in Pregnancy > Flashcards

Drugs in Pregnancy Flashcards

1
Q

Describe a teratogen

A

Causes abnormality within baby following foetal exposure during pregnancy

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2
Q

When is pregnancy most vulnerable to teratogens?

A

First half of pregnancy
Affects embryogenesis

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3
Q

What are preventable teratogens?

A

Alcohol, smoking and drugs

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4
Q

What can alcohol in pregnancy cause?

A

Foetal alcohol syndrome

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5
Q

What can smoking in pregnancy cause?

A

Low birth weight, preterm birth, cerebral palsy and learning difficulties

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6
Q

What can drugs like marijuana, ecstasy and cocaine cause during pregnancy?

A

Low birth weight, withdrawal symptoms, learning and behavioural problems

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7
Q

What is pharmacokinetics?

A

What the body does to a drug
Movement of drug through and out of the body
Absorption, bioavailability, distribution, metabolism and excretion

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8
Q

What is pharmacodynamics?

A

What the drug does to the body
Biochemical, physiological and molecular effects of drug
Receptor binding/ post receptor effect

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9
Q

What can normal physiological changes in pregnancy lead to for pharmacokinectics and pharmacodynamics?

A

Alteration in pharmacokinetics of the drug and may affect the pharmacodynamics

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10
Q

What did thalidomide cause?

A

Phocomelia

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11
Q

What is first line for nausea and vomiting in pregnancy?

A

Cyclizine - antihistamine
Prochlorperazine - phenothiazine
Doxylamine/ pyridoxine combination

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12
Q

What is second line for nausea and vomiting in pregnancy?

A

Ondansetron
Metoclopramide

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13
Q

What can be used to treat hypertension in pregnancy?

A

Labetolol, nifedipine, methyldopa and hydralazine

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14
Q

What are some hypertension teratogenic medicines?

A

ACE inhibitors and angiotensin receptor antagonist
Change as soon as pregnancy is confirmed

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15
Q

What are the safest drugs to use for epilepsy in pregnancy?

A

Carbamazepine and lamotrigine
Always give high dose of folic acid

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16
Q

What does pregnancy change in antiepileptics?

A

Free serum conc.

17
Q

What can phenobarbitone cause if taken during pregnancy?

A

Cardiac malformations

18
Q

What can sodium valproate cause if taken during pregnancy?

A

NTD and facial clefts

19
Q

What is the safest medication to use in diabetes?

A

Insulin

20
Q

What medication is given in gestational diabetes/ type 2 diabetes?

A

Metformin

21
Q

What thromboembolism medication is safe during pregnancy?

A

Low molecular weight heparin (LMWH)

22
Q

What can warfarin cause if taken during pregnancy?

A

Foetal warfarin syndrome/ foetal embryopathy
Nasal hypoplasia, stippled epiphyses and skeletal abnormalities
Avoid in 1st and 3rd trimesters

23
Q

Can DOACs (apixaban, dabigatran and rivaroxaban) be used during pregnancy?

A

Advised to avoid during pregnancy due to animal toxicity

24
Q

What B2 agonists are used for asthma during pregnancy?

A

Albuterol and salbutamol

25
Q

What inhaled corticosteroid can be used for asthma during pregnancy?

A

Budesonide

26
Q

What is used for severe asthma during pregnancy?

A

Systemic corticosteroid used

27
Q

Can theophylline be taken during pregnancy?

A

No as potential toxicity

28
Q

What medications can be taken for headaches and migraines during pregnancy?

A

Paracetamol
Ibuprofen - avoid in 3rd trimester - persistent pulmonary hypertension
Sumatriptan
Propranolol lowest effective dose

29
Q

Describe morphine based medicines during pregnancy

A

No increase in congenital abnormalities
Risk of neonatal resp depression and withdrawal
Used as labour analgesia
Avoid codeine during lactation

30
Q

What antidepressants and antipsychotics can be taken during pregnancy?

A

SSRI where benefits of use outweigh the potential risks then they can be indicated
Destabilisation and maternal relapse should be considered

31
Q

What can lithium cause if taken during pregnancy?

A

Ebstein’s anomaly - cardiac anomaly

32
Q

What can diazepam cause if taken during pregnancy??

A

Cleft lip/ palate
Floppy infant syndrome

33
Q

What can quetiapine cause if taken during pregnancy?

A

Large baby and poor neonatal adaption syndrome

34
Q

What antibiotics are safe to be taken during pregnancy?

A

Penicillin
Macrolides - azithromycin/ erythromycin only if no alternative
Cephalosporins

35
Q

What antibiotics should not be taken during pregnancy?

A

Tetracycline - skeletal development problems and discolouration of teeth
Sulphonamides - teratogenic in 1st trimester and folate antagonist
Aminoglycosides - auditory or vestibular nerve damage

36
Q

When is the risk of aminoglycosides the greatest if taken during pregnancy?

A

When taken with streptomycin

37
Q

Describe cancer treatments during pregnancy

A

Most cytotoxic drugs are teratogenic
Exclude pregnancy before starting these medications
Take specialist advise

38
Q

Can hydroxychloquine be used for corona virus treatment during pregnancy?

A

No significant increased risk of major malformations
No increase in stillbirth, low birth weight or prematurity risks

39
Q

What corona virus treatments can be taken during pregnancy?

A

Hydroxyxhloquine
Azithromycin - macrolide antibiotics
Tocilizumab
Lopinavir/ ritonavir - protease inhibitors
Corticosteroids

Reproductive System (18 decks)

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