Medications - Adverse Effects in Pregnancy

Question 1

complication of NSAIDs in pregnancy for:

the foetus

the mother

Answer 1

closure of the ductus arteriosus

delayed labour (PGs mediate contractions)

Question 2

when in the pregnancy should NSAIDs be particularly avoided?

Answer 2

in the 3rd trimester

Question 3

3 complications of beta-blockers in the foetus

Answer 3

foetal growth restriction

foetal hypoglycaemia

foetal bradycardia

Question 4

which beta blocker is safe in pregnancy?

Answer 4

labetalol

Question 5

2 parts of the foetus which are affected by ACEIs and ARBs

Answer 5

the kidney (obviously)

the bones of the skull

Question 6

5 foetal AEs of ACEIs and ARBs

Answer 6

oligohydramnios

neonatal hypotension

renal failure in the neonate

hypocalvia (incomplete growth of the bones of the skull)

miscarriage/foetal death (presumably as a result of some of the above)

Question 7

symptoms of neonatal withdrawal from opiates

Answer 7

high temperature

irritability

poor feeding

tachypnoea

Question 8

other than miscarriage and PPH, what are the problems associated with warfarin in pregnancy?

Answer 8

congenital malformations - particularly craniofacial

Question 9

which drug causes Ebstein’s anomaly?

Answer 9

lithium

Question 10

what is Ebstein’s anomaly?

Answer 10

tricupsid valve sits lower within the right ventricle and therefore the RA is larger than normal and the RV is smaller than normal

Question 11

true or false: lithium can be restarted immediately after pregnancy

Answer 11

false, it is toxic to the baby if the mother is breastfeeding

Question 12

risks associated with SSRIs in the first trimester

risks associated with SSRIs in the third trimester

Answer 12

congenital heart defects

PPHN

Question 13

which SSRI is particularly associated with congenital malformations?

Answer 13

paroxetine

Question 14

true or false: neonates tend to experience severe withdrawal symptoms from SSRIs

Answer 14

false - they tend to be mild