Drugs in Pregnancy and Lactation

Question 1

women with what 3 medical diagnoses must continue therapy during pregnancy?

Answer 1

hypertension
diabetes
epilepsy

Question 2

what is increased in the physiology during pregnancy? (3)

Answer 2

intestinal transit time
pulmonary blood flow
tidal volume

Question 3

what is decreased in the physiology during pregnancy?

Answer 3

gastric emptying

Question 4

an agent that produces a congenital defect

Answer 4

teratogen

Question 5

drugs administers for condition which itself is teratogenic

Answer 5

prednisone for lupus

Question 6

malformation causes symptoms which then prompt treatment with a drug

Answer 6

antacids for esophageal atresia

Question 7

drug inhibits abortion of an already malformed fetus

Answer 7

progestins

Question 8

drug frequently used with a second drug which is teratogenic

Answer 8

phenobarbital / dilantin

Question 9

common risk factors for drug use and anomalies

Answer 9

age / clomid

Question 10

drugs that have a 2-3x increased risk for neural tube defect caused by impairing folic acid metabolism

Answer 10

anti-seizure drugs

Question 11

what is the fetal hydantoin syndrome mnemonic?

Answer 11

P - cleft Palate/lip

H - small Head, Hirsutism, Hypoplastic face, Heart defects

E - Embryopathy, anti-Epileptic use

N - hypoplastic Nails, Neurological defects

Question 12

what does warfarin cause in the 1st trimester?

Answer 12

fetal warfarin syndrome

Question 13

what does warfarin cause in the 2nd trimester? (2)

Answer 13

mental retardation
blindness

Question 14

what does warfarin cause in the 3rd trimester? (2)

Answer 14

hemorrhage
stillbirth

Question 15

characterized by microcephaly, nasal hypoplasia, stippled vertebrae, and femoral epiphyses

Answer 15

coumadin embryopathy

Question 16

drugs that cause fetal/neonatal renal failure, leading to oligohydramnios, pulmonary hypoplasia, intrauterine growth restriction, and stillbirth

Answer 16

ACE inhibitors

Question 17

drug that increases the risk of miscarriage and causes cranial nerve palsy, limb malformations, and craniofacial abnormalities when used in the 1st trimester

Answer 17

misoprostol

Question 18

drug that causes ebstein’s anomaly (major cardiac defect)

Answer 18

lithium

Question 19

drug that readily crosses the placenta, stains the deciduous teeth, causes enamel hypoplasia, and inhibits bone growth

Answer 19

tetracycline

Question 20

drugs used to treat endometriosis, but causes virilization of female fetuses exposed before 13 weeks; clitoromegaly and labial fusion

Answer 20

danazol

Question 21

drug that should be avoided in the 1st trimester, is carcinogenic to rodents without associated malformation in humans

Answer 21

metronidazole

Question 22

drugs that can cause autotoxicity

Answer 22

aminoglycosides

Question 23

drug that competes with bilirubin-binding sites, which can lead to hyperbilirubinemia

Answer 23

sulfonamides

Question 24

drugs that have a high affinity for bones and cartilage and causes arthropathy in children

Answer 24

fluoroquinolones

Question 25

what is the leading preventable cause of birth defects?

Answer 25

drinking alcohol during pregnancy

Question 26

alcohol intake that causes functional and growth disturbances

Answer 26

1-2 oz/day

Question 27

alcohol intake that causes 50% abnormal

Answer 27

> 3oz/day

Question 28

characterized by absent philtrum, midface hypoplasia, low nasal bridge, low set ears, microcephaly, and shortened palpebral fissures.

Answer 28

fetal alcohol syndrome

Question 29

illicit drug that causes vascular disruptions

Answer 29

cocaine

Question 30

illicit drug that does not have any clinical effect

Answer 30

LSD

Question 31

illicit drug that has dose-related intrauterine growth restriction

Answer 31

marijuana

Question 32

illicit drug that causes intrauterine growth restriction, cardiac defects, and facial clefts

Answer 32

amphetamines

Question 33

illicit drugs that cause neonatal withdrawal (2)

Answer 33

heroin/methadone

Question 34

toxin that causes neurological abnormalities and microcephaly

Answer 34

mercury

Question 35

toxin that causes developmental delays, decreased IQ, and minor malformations

Answer 35

lead

Question 36

what 2 medications are contraindicated during lactation?

Answer 36

methotrexate
lithium

Question 37

what can be used to find medications that are safe in pregnancy?

Answer 37

LactMed