Medications During Pregnancy

Question 1

Sudafed

Answer 1

Safe as long as not hypertensive

Question 2

Pyridoxine (Vitamin B6)

Answer 2

• Used for nausea/vomiting.
• Dosing:
  
  • 10 - 25 mg PO, tid-qid. Titrate based on symptoms
  • Can also give in combo with doxylamine 12.5 mg
• Combination medications:
  
  • Pyridoxine 10 mg/doxylamine 10 mg, 2 tabs qHS
    
    • can increase up to 4 tabs/day (AM, midday, 2 tabs PM)
    • aka Diclegis
  • Pyridoxine 20 mg/doxylamine 20 mg
    
    • can increase up to 2 tabs/day (ie AM/PM)

Question 3

2nd/3rd line pharm options for persistant nausea despite pyridoxine/doxylamine

Answer 3

SECOND LINE

PO

• Dimenhydrinate (Dramamine) 25 - 50 mg, q 4-6 hours
  
  • (limit to 200 mg if also taking doxylamine)
• Diphenhydramine (Benedryl) 25 - 50 q 4-6 hours

Rectal

• Prochloroperazine (compazine) 25 mg q 12 hours
• Promethazine (phenergan) 12.5 - 25 q 4 - 6 hours

THIRD LINE → if no dehydration

• Metoclopramide PO/IM
• Odansatron PO
• Promethazine PO/PR/IM
• Trimethobenzamide IM

Question 4

Acetaminophen

Answer 4

325 - 650 mg q 4 - 6 hours

*limit to 3,000 mg q day

Question 5

Bulk-forming laxatives

Answer 5

• 1st line if lifestyle measures fail
• Fiber supplements with oat bran or wheat fiber in a pill, powder, liquid or chewable form
• Citrucel, Metamucil, FiberCon, Benefiber
• Side effects: bloating, cramping
• Takes 2-3 days to work

Question 6

Stool softeners/osmotic laxatives

Answer 6

• 2nd line if bulk-forming laxatives (and lifestyle measures) dont work
• Prevent hardening of the feces by adding water
• Miralax, Colace, etc
• Side effects: bloating/cramping
• Quicker relief than bulk-forming