Drugs in Pregnancy Labor and Lactation Flashcards
Factors that influence drugs’ passage across placenta
How drugs affect fetus
How drugs affect the fetus depends on
Stages at which fetus is affected
Effect of drugs administered during implantation stage
May lead to failure of pregnancy
eg. Methotrexate (anticancer drug)
Alcohol
Effect of drugs adminstered during organogenesis
Teratogenicity of thalidomide
Teratogenicity of Retinoids
Skeletal deformities (strong)
Teratogenicity of methotrexate
Cleft palate/hydrocephalus
Teratogenicity of Phenytoin
Teratogenicity of Valproate
Teratogenicity of Warfarin
Nasal hypoplasia
Teratogenicity of diethylstilbestrol
Adenocarsinoma of vagina in teenage years of the daughter
Teratogenecity during the G and D stage
Drugs given at end of pregnancy ie before or during labor
Effect of Asprin
Effects of Sulfonamides
Effect of BZDs and Opiates
More teratogenic drugs
FDA RISK CATEGORIES
Effect of Pregnancy on Distribution
Effect of drug on elimination
Common chronic conditions in pregnancy
Concerns with antiepileptic drugs
Factors controlling transfer of drug to breast milk
- Lipid solu
- MW
- Ionization
- Blood flow
Note: most enter blood but at small amounts
Drugs safe during breast feeding
Drugs avoided during breast feeding
Minimizing effects during breast feeding
- Avoid if possible
- Safest effective medicine
- LOWEST possible dose
- Take immediately after breast feeding
- Lactation risk guidelines
