Drugs used in pregnancy Flashcards
What is adequate folic acid for a woman of childbearing age
400-800 mcg daily (0.4-0.8 mg/day)
what is adequate calcium for a woman of childbearing age
1000 mg daily
what is adequate vitamin d for a woman of childbearing age
600 iu daily
What does adequate folic acid prevent in preganancy
Birth defects of brain and spinal cord
Treatment of N/V – first line
Pyridoxine +/- doxylamine
First line for GERD/heartburn/gas pain
Antacids – calcium carbonate (tums)
First line for gas in pregnancy
Simethecone
First line constipation in pregnancy
Fiber
Psyllium (Metamucil – is category B)
First line cough/cold/allergies in pregnancy
First line antihistamines i. Chlorpheniramine ii. Diphenhydramine Nonsedating 2nd generations i. Loratidine ii. Cetirizine iii. SECOND AND THIRD TRIMESTERS
Analgesic/antipyretic drug of choice in pregnancy
Acetaminophen
NO OTC NSAIDS
decongestants in pregnancy
Oral decongestants should not be recommended in the first trimester but pseudophedrine, phenylephrine, oxymetazoline may be prescribed by a physician in the second and third trimesters
i. Category c
Antibiotics considered safe in preganacy
a. Penicillins
b. Cephalosporins
c. Erythromycin
d. Azithromycin
e. Not clarithromycin
Antibiotics to avoid in preg
a. Quinolones
b. Tetracyclines
Vaccines during pregnancy to avoid
a. All live vaccines – MMR, Vericella, live Flu, etc
b. And one month before if possible
When can TDap Be given in preg and what if a women has delivered and not gotten
a. Needs to get right after delivery
b. Do not give between 27-36 weeks gestation
What is the treatment for vaginal fungal infections in preg
Topical antifungals for at least 7 days
What is the treatment of choice for urinary tract infections in preg
a. Beta lactams
i. Cephalexin (500mg qid) or ampicillin
b. Nitrofurantoin 100mg bid – not used in the last several wks of preg
How long is the treatment for preg bacteremia
7 days even if asymptomatic with negative uranalysis
When should SMX/TMP be avoided in preg and why
a. 3rd trimester
b. Can call hyperbilirubinemia and kernicterus
When is nitrofurantoin not indicated in pregnancy
Last few weeks
What is the treatment for chlamydia in preg
a. Azithromycin 1g x 1
b. Amoxicillin 500mg tidx7d
What is the treatment for gonorrhea in preg
Cephalosporin or if contraindicated azithromycin 2gx1
What is the treatment for bacterial vaginosis in preg
a. clindamycin 300mg bid or metronidazole 500mg bid for 250mg tid x7 days
b. topical therapy not recommended in preg
2what is the treatment for vaginal trichomoiasis
2g metronidazole x1 (or 250 mg pot id or 500mg bid x7d)
When might treatment be deterred with vaginal trichomoiasis
after 37 weeks
What is the treatment for hyperthyroidism (especially graves)
a. Both drugs are category D
b. Propylthiouracil is used if trying to convieve and in 1st trimester then can switch to methimazole
