Obs and gynae Flashcards
What is the first-line medication for nausea and vomiting in pregnancy?
Cyclizine 50mg TDS PO/IV/IM
Well tolerated
What dose of Promethazine is recommended for nausea in pregnancy?
25mg ON, max 100mg daily
Causes drowsiness
What is the maximum duration of Metoclopramide use in pregnancy?
5 days
Risk of dystonia
What is the second-line medication for nausea and vomiting in pregnancy?
Ondansetron 4-8mg BD PO/IV
Small risk of cleft palate
What is the recommended treatment for severe cases of nausea in pregnancy?
IV fluids (0.9% NaCl + KCl)
Also thiamine supplementation
What is the first-line medication for chronic hypertension in pregnancy?
Labetalol 100mg BD, max 800mg TDS
Avoid in asthma
What is the alternative medication for chronic hypertension if Labetalol is unsuitable?
Nifedipine MR 10mg BD, max 40mg BD
Used if asthmatic or intolerant
What is the initial IV bolus dose for Labetalol in severe pre-eclampsia?
20mg IV bolus
Repeat every 10 min, monitor BP closely
What is the first-line medication for eclampsia?
Magnesium sulfate IV 4g over 10 min, then 1g/hr infusion
Prevents seizures
What medication is recommended for neuroprotection before 30 weeks in preterm labour?
Magnesium sulfate IV 4g over 10 min, then 1g/hr infusion
Reduces cerebral palsy risk
What is the first-line tocolytic for preterm labour under 34 weeks?
Nifedipine MR 20mg stat, then 10-20mg QDS
First-line tocolytic
What is the first-line medication for vasomotor symptoms in menopause?
Estradiol + Norethisterone (Elleste Duet) 1 tablet OD
For women with intact uterus
What is the recommended treatment for vaginal dryness in menopause?
Estriol cream 0.5mg vaginally twice weekly
No systemic absorption
What is the first-line treatment for irregular periods in PCOS?
COC (Microgynon, Yasmin) 1 tablet OD
Reduces hyperandrogenism
What medication is used for fertility treatment in PCOS?
Letrozole 2.5-5mg OD from day 2-6 of cycle
First-line ovulation induction
What is the first-line treatment for urge incontinence?
Oxybutynin 2.5-5mg BD/TDS
Anticholinergic side effects
What is the alternative medication for urge incontinence if cognitive impairment is present?
Mirabegron 50mg OD
Avoid in uncontrolled hypertension
What is the first-line medication for urinary tract infection in pregnancy?
Nitrofurantoin 100mg MR BD for 7 days
Avoid after 36 weeks
What is the alternative medication for UTI in pregnancy if Nitrofurantoin is unsuitable?
Cefalexin 500mg BD for 7 days
Recommended for UTIs
True or False: Preterm labour requires steroids and tocolysis if no contraindications exist.
True
Essential for management
Fill in the blank: Hormonal contraception must be tailored to _______.
[risk factors]
Consider clot risk, migraine, etc.
What is a preferred method of hormone replacement therapy if there is a risk of VTE?
Transdermal patches
Safer option for HRT
