N+V in pregnancy 2

Question 1

is ondansetron allowed in 1st trimester

Answer 1

yes but advise that risk of cleft lip/palate

Question 2

duration of ondansetron

Answer 2

max 5 days

Question 3

true or false - if pt doesnt respond to single anti emetic, can you use combination

Answer 3

yes. consider using combinations.
many women will require more than 1 antiemetic to control symptoms; some may require combo of 3 or more

Question 4

If second-line combinations of treatments are ineffective the third-line treatment is:

Answer 4

oral prednisolone 40-50mg daily
steroid dose should be gradually tapered until the lowest maintenance dose which controls symptoms has been reached

Question 5

If you give CC (oral prednisolone) as 3rd line treatment for n+v, what must you do and can it be given alone?

Answer 5

Corticosteroids should be reserved for people where standard treatments have failed. The should be prescribed in addition to previously initiated antiemetics. Women on oral corticosteroids should have regular blood pressure monitoring and screening for diabetes mellitus.

Question 6

if 3rd line treatment ineffective (oral prednisolone), what do you do

Answer 6

refer to specialist

Question 7

when may it be possible to stop antiemetic therapy

Answer 7

around 12–16 weeks of pregnancy when symptoms have usually improved.
gradually tapering the dose may reduce the risk of symptoms recurring