Drugs in Pregnancy and Lactation Flashcards
women with what 3 medical diagnoses must continue therapy during pregnancy?
hypertension
diabetes
epilepsy
what is increased in the physiology during pregnancy? (3)
intestinal transit time
pulmonary blood flow
tidal volume
what is decreased in the physiology during pregnancy?
gastric emptying
an agent that produces a congenital defect
teratogen
drugs administers for condition which itself is teratogenic
prednisone for lupus
malformation causes symptoms which then prompt treatment with a drug
antacids for esophageal atresia
drug inhibits abortion of an already malformed fetus
progestins
drug frequently used with a second drug which is teratogenic
phenobarbital / dilantin
common risk factors for drug use and anomalies
age / clomid
drugs that have a 2-3x increased risk for neural tube defect caused by impairing folic acid metabolism
anti-seizure drugs
what is the fetal hydantoin syndrome mnemonic?
P - cleft Palate/lip
H - small Head, Hirsutism, Hypoplastic face, Heart defects
E - Embryopathy, anti-Epileptic use
N - hypoplastic Nails, Neurological defects
what does warfarin cause in the 1st trimester?
fetal warfarin syndrome
what does warfarin cause in the 2nd trimester? (2)
mental retardation
blindness
what does warfarin cause in the 3rd trimester? (2)
hemorrhage
stillbirth
characterized by microcephaly, nasal hypoplasia, stippled vertebrae, and femoral epiphyses
coumadin embryopathy
drugs that cause fetal/neonatal renal failure, leading to oligohydramnios, pulmonary hypoplasia, intrauterine growth restriction, and stillbirth
ACE inhibitors
drug that increases the risk of miscarriage and causes cranial nerve palsy, limb malformations, and craniofacial abnormalities when used in the 1st trimester
misoprostol
drug that causes ebstein’s anomaly (major cardiac defect)
lithium
drug that readily crosses the placenta, stains the deciduous teeth, causes enamel hypoplasia, and inhibits bone growth
tetracycline
drugs used to treat endometriosis, but causes virilization of female fetuses exposed before 13 weeks; clitoromegaly and labial fusion
danazol
drug that should be avoided in the 1st trimester, is carcinogenic to rodents without associated malformation in humans
metronidazole
drugs that can cause autotoxicity
aminoglycosides
drug that competes with bilirubin-binding sites, which can lead to hyperbilirubinemia
sulfonamides
drugs that have a high affinity for bones and cartilage and causes arthropathy in children
fluoroquinolones
what is the leading preventable cause of birth defects?
drinking alcohol during pregnancy
alcohol intake that causes functional and growth disturbances
1-2 oz/day
alcohol intake that causes 50% abnormal
> 3oz/day
characterized by absent philtrum, midface hypoplasia, low nasal bridge, low set ears, microcephaly, and shortened palpebral fissures.
fetal alcohol syndrome
illicit drug that causes vascular disruptions
cocaine
illicit drug that does not have any clinical effect
LSD
illicit drug that has dose-related intrauterine growth restriction
marijuana
illicit drug that causes intrauterine growth restriction, cardiac defects, and facial clefts
amphetamines
illicit drugs that cause neonatal withdrawal (2)
heroin/methadone
toxin that causes neurological abnormalities and microcephaly
mercury
toxin that causes developmental delays, decreased IQ, and minor malformations
lead
what 2 medications are contraindicated during lactation?
methotrexate
lithium
what can be used to find medications that are safe in pregnancy?
LactMed
