Drugs used in pregnancy

Question 1

What is adequate folic acid for a woman of childbearing age

Answer 1

400-800 mcg daily (0.4-0.8 mg/day)

Question 2

what is adequate calcium for a woman of childbearing age

Answer 2

1000 mg daily

Question 3

what is adequate vitamin d for a woman of childbearing age

Answer 3

600 iu daily

Question 4

What does adequate folic acid prevent in preganancy

Answer 4

Birth defects of brain and spinal cord

Question 5

Treatment of N/V – first line

Answer 5

Pyridoxine +/- doxylamine

Question 6

First line for GERD/heartburn/gas pain

Answer 6

Antacids – calcium carbonate (tums)

Question 7

First line for gas in pregnancy

Answer 7

Simethecone

Question 8

First line constipation in pregnancy

Answer 8

Fiber

Psyllium (Metamucil – is category B)

Question 9

First line cough/cold/allergies in pregnancy

Answer 9

First line antihistamines
i.	Chlorpheniramine
ii.	Diphenhydramine
Nonsedating 2nd generations
i.	Loratidine
ii.	Cetirizine 
iii.	SECOND AND THIRD TRIMESTERS

Question 10

Analgesic/antipyretic drug of choice in pregnancy

Answer 10

Acetaminophen

NO OTC NSAIDS

Question 11

decongestants in pregnancy

Answer 11

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

Question 12

Antibiotics considered safe in preganacy

Answer 12

a. Penicillins
b. Cephalosporins
c. Erythromycin
d. Azithromycin
e. Not clarithromycin

Question 13

Antibiotics to avoid in preg

Answer 13

a. Quinolones

b. Tetracyclines

Question 14

Vaccines during pregnancy to avoid

Answer 14

a. All live vaccines – MMR, Vericella, live Flu, etc

b. And one month before if possible

Question 15

When can TDap Be given in preg and what if a women has delivered and not gotten

Answer 15

a. Needs to get right after delivery

b. Do not give between 27-36 weeks gestation

Question 16

What is the treatment for vaginal fungal infections in preg

Answer 16

Topical antifungals for at least 7 days

Question 17

What is the treatment of choice for urinary tract infections in preg

Answer 17

a. Beta lactams
i. Cephalexin (500mg qid) or ampicillin
b. Nitrofurantoin 100mg bid – not used in the last several wks of preg

Question 18

How long is the treatment for preg bacteremia

Answer 18

7 days even if asymptomatic with negative uranalysis

Question 19

When should SMX/TMP be avoided in preg and why

Answer 19

a. 3rd trimester

b. Can call hyperbilirubinemia and kernicterus

Question 20

When is nitrofurantoin not indicated in pregnancy

Answer 20

Last few weeks

Question 21

What is the treatment for chlamydia in preg

Answer 21

a. Azithromycin 1g x 1

b. Amoxicillin 500mg tidx7d

Question 22

What is the treatment for gonorrhea in preg

Answer 22

Cephalosporin or if contraindicated azithromycin 2gx1

Question 23

What is the treatment for bacterial vaginosis in preg

Answer 23

a. clindamycin 300mg bid or metronidazole 500mg bid for 250mg tid x7 days
b. topical therapy not recommended in preg

Question 24

2what is the treatment for vaginal trichomoiasis

Answer 24

2g metronidazole x1 (or 250 mg pot id or 500mg bid x7d)

Question 25

When might treatment be deterred with vaginal trichomoiasis

Answer 25

after 37 weeks

Question 26

What is the treatment for hyperthyroidism (especially graves)

Answer 26

a. Both drugs are category D

b. Propylthiouracil is used if trying to convieve and in 1st trimester then can switch to methimazole