Medications In Pregnancy Flashcards
NSAIDs
Avoided in pregnancy unless necessary e.g. in RA
Particularly avoided in the third trimester - cause premature closure of the ductus arteriosus in the fetus
Can also delay labour
Beta-blockers
Labetalol used in pregnancy as safe
Other beta blockers can cause:
- Fetal growth restriction
- Hypoglycaemia in the neonate
- Bradycardia in the neonate
ACE Inhibitors and Angiotensin II Receptor Blockers
Can cross the placenta
Affect the kidneys and reduces the production of urine (and therefore amniotic fluid) - Oligohydramnios
Hypocalvaria - incomplete formation of the skull
Miscarriage
Renal failure in the neonate
Hypotension in the neonate
Opiates in pregnancy
Causes withdrawal symptoms in the neonate after birth - neonatal abstinence syndrome
Neonatal abstinence syndrome presentation
Irritability
Tachypnoea (fast breathing)
High temperatures
Poor feeding
When does neonatal abstinence syndrome present
Between 3 – 72 hours after birth
Warfarin in pregnancy causes
Avoided in pregnancy
Can cause:
- Fetal loss
- Congenital malformations, particularly craniofacial problems
- Bleeding during pregnancy
- postpartum haemorrhage
- Fetal haemorrhage and intracranial bleeding
Sodium Valproate in pregnancy effects
Neural tube defects
Developmental delay
Lithium in pregnancy effects
Avoided in the first trimester - congenital cardiac abnormalities.
Associated with Ebstein’s anomaly
Lithium enters breast milk and is toxic to the infant - avoided in breastfeeding.
Lithium monitoring during pregnancy
Levels monitored every four weeks, then weekly from 36 weeks).
SSRIs in pregnancy effects
First-trimester - congenital heart defects
(especially paroxetine)
Third-trimester - persistent pulmonary hypertension in the neonate
Neonates can experience mild withdrawal symptoms
Isotretinoin in pregnancy effects and precautions
Highly teratogenic - causing miscarriage and congenital defects.
Women need very reliable contraception before, during and for one month after taking isotretinoin
