Module 5 Flashcards
HG treatment pregnancy category
Diclegis : Category A
Promethazine: Category C
Metoclopramide: Category B
Ondansetron (Zofran) : Category B
Mechanism of action for Diclegis
Antihistamine (H1 blocker) with Vitamin B6 10mg/plus doxylamine 10 mg
Mechanism of action for Promethazine (Phenergan)
Weak antidopaminergic antiserotonin receptor activity in CNS antimuscarinic Long lasting antihistamine aciton
Mechanism of action forMetoclopramide (Reglan)
Anti HT# antidopaminergic properties/Prokinetic agent
Mechanism of action for Ondanesetron (Zofran)
Selective 5 HT receptor antagonist
Positive urine culture results
ASB > 100,000
Cystitis > 1,000
Pyelonephritis > 10,000
Commonly used abx in UTI in pregnant women
Nitrofurantoin (Macrobid) 100 mg PO BID x 5-7 days
Amoxicillin: 500 mg PO BID for 5-7 days
Augmentin: 500/125 PO BID got 3-7 days
Cephalexin: 500 mg PO BID x 3-7 days
Cefuroxime: 250 mg PO BID x 3-7 days
Fosfomycin: 3 gram PO x 1 with 3-4 ounces of water
Why not to use Macrobid the last couple weeks of pregnancy
Can cause hemolytic anemia in the fetus or neonate
When to test of cure (TOC) for UTI treatment
1-2 weeks after therapy
If Test of cure (TOCP not negative in 1-2 weeks what should be done
treat 10-14 days with another antibiotic and then begin suppressive therapy
Antibiotics not to use in pregnancy
Tetracyclines: adverse effect on fetal teeth, bones and congenital defects
Trimethoprim in first trimester: facial defects and cardiac abnormalities
Chloramphenicol: Gray syndrome
Sulfonamides in 3rd trimester: hemolytic anemia in mothers with G6PD deficiency, jaundice, kernicterus
Fluoroquinolone:
Only use in those with limited treatment options: only when benefit outweighs risk
Have been associated with serious adverse effects involving tendons, muscles, joints, nerves, and the CNS
Caution in Pyelonephritisq
Pregnant women with pyelonephritis are at high risk for developing Adult respiratory distress syndrome (ARDS) and pulmonary edema
Pregnant women with pyelonephritis have higher rates of still birth, fetal loss and preterm labor
People with pyelo can develop septic shock, respiratory insufficiency if not adequately treated
untreated upper urinary tract infections are associated with low birth weight, prematurity, preterm labor, hypertension, preeclampsia, maternal anemia and amnionitis
When does most gallbladder stones develop
2nd and 3rd trimester
ASB incidence
2-7% of pregnancies
Highest incidence
AA with sickle traits
Lowest incidence
Affluent, low parity, white
30% recurrence
If untreated 25-35% pyelonephritis
Cystitis incidence
15-20% of pregnancies
