Meds and Pregnancy Flashcards
If patient takes a med that’s bad for the baby what happens in week 2-4, week 4-13, week 13?
2-4: all or nothing
4-13: embryonic period-> anomalies
>13: fetal period-> ??
What to take when pregnant with a URI?
acetaminophen is great!
NyQuil, cough drops, nasal spray all good
Caution pregnant people taking phenylephrine in pts with ____
cHTN or gHTN/preX (its a vasoconstrictor)
What to take when pregnant with heartburn?
antacid, famotidine, omeprazole
can even take them together
What to take when pregnant with allergies?
diphenhydramine, loratadine, cetirizine
What to take when pregnant with constipation?
stool softener, miralax, glycerin, bisacodyl are all great
What is OTC that is NOT safe in pregnant individuals
NSAIDs (renal development concern, closure of DA)
aspirin is ok
Pregnancy with cHTN, what meds to be on ____. What is bad?
β blocker, Ca channel, diuretics, methyldopa
ACE-Is and ARBs-> renal anomalies
Pregnancy with asthma, what meds to be on ____. What is bad?
SABA, anticholinergics (ipratropium), inhaled corticosteroids, LABA
No: oral corticosteroids (prednisone), particularly in first trimester
Pregnancy with depression/anxiety, what meds to be on ____. What is bad?
SSRIs, SNRIs, 2nd gen antipsychotics (withdrawal in baby = 48 hours of fussy baby)
Not good but not B A D: benzos, Li, ?Lamotrigine?
What is the risk to the baby for a pregnant person on Lithium?
Ebstein anomaly (tricuspid valve not formed well) (mom can be on it, need to discuss the risk benefits)
Pregnancy with diabetes, what meds to be on ____. What is bad?
metformin, sulfonylureas (bad for actual glycemic control), insulins
No idea: α-glucosidase inhibitors, DDP-4s, GLP-1, meglitinides, SGLT2s
Pregnancy with hypothyroidism, what meds to be on ____. What is bad?
Levothyroxine (in pregnancy they will need more (30% increase))
Pregnancy with anticoagulation, what meds to be on ____. What is bad?
heparin/LMWH
bad: Coumadin
No idea: DOAC
Pregnancy with UTI, what meds to be on ____. What is bad?
PCN/cephalosporins, nitrofurantoin, clindamycin, bactrim (îs ok but not for UTI)
Bad: fluoroquinolone, tetracyclines
What is pediatric complication with Bactrim
liver stuff
What are good options for pregnant patients with N/V
1st line: B6 and Doxylamine
promethazine, prochlorperazine, ginger, scopolamine, zofran (post 10 weeks)
When baby is likely to deliver soon but between 22-34 weeks they should be given ___. Why does this work?
corticosteroids (dexamethasone or betamethasone)
Changes the way the lungs are developing from type 1 to type 2 pneumocytes
Labor inducing drugs
misoprostol
Pitocin
Tocolysis (stopping contractions) can be done with ___ acutely and ___ preterm
Acute: terbutaline (fast acting to help baby recover)
Preterm (<34wks): NSAIDs (short 48 interval between 16-32 weeks), Nifedipine (Ca2+), Mg sulfate
What antibiotics to use for:
group B strep prophylaxis
intra-amniotic infection
endometritis
group B strep prophylaxis: penicillin or ampicillin
intra-amniotic infection: ampicillin/gentamycin
endometritis: gentamycin/clindamycin
What medications to use for severe preeclampsia
Prevent seizures: Mg sulfate
Acutely lower BP: hydralazine, labetalol, nifedipine