Obs and Gynae Pharmacology Flashcards
definition of hyperemesis gravidarum?
loss of 5% of body weight
dehydration
electrolyte disturbance
first line anti-emetics in hyperemesis gravidarum?
cyclizine
promethazine
antihistamines
how are anti-emetics given in hyperemesis gravidarum?
IV
(but be careful with cyclizine IV as it can make people v dizzy esp if dehydrated)
can give IM if they dont have IV access
second line anti-emetics in hyperemesis gravidarum?
metoclopramide
ondansetron
(generally try metoclopramide before ondansetron as ondansetron can cause cleft palate)
is there any risks with metoclopramide?
extra-pyramidal side effects
dose of cyclizine?
50mg
other drugs which can be given alongside anti-emetics in hyperemesis gravidarum?
thiamine/pabrinex
folic acid
PPI/ranitidine
fluid prescribing in hyperemesis gravidarum?
1L saline with 20mmol K+ over 2 hrs (twice)
maybe? not sure? might be wrong who knows
what analgesia can be given in pregnancy?
paracetamol usually first line
can also give codeine 2nd line
what analgesia should you not prescribe in pregnancy and why?
NSAIDs
risk of closing ductus arteriosus causes neonatal pulmonary hypertension
what analgesia is safe in breastfeeding eg for pain after C-section?
paracetamol
NSAIDs
dihydrocodeine
can also give lactulose to help as most women are constipated after C-section
codeine before/after birth?
antenatal = codeine post-natal = dihydroceodeine
how long do you need to stop methotrexate for before pregnancy?
3 months
management of UC in pregnancy?
5-ASA (mesalazine) is safe to use but should be taking folic acid alongside
some DMARDs are safe
steroids fine
biologics (eg infliximab) ok but try to avoid in 3rd trimester
what DMARDs are safe in pregnancy?
sulfasalazine
hydroxychloroquine
is metronidazole safe in pregnancy?
yes
antibiotics for PID?
doxycycline
metronidazole
ceftriaxone
what should doxycycline should be swapped for if pregnant in PID?
erythromycin
management of anaphylaxis due to antibiotic allergy?
stop antibiotic and press button on wall for help oxygen fluids (stat) anti-histamine steroids (IV hydrocortisone) 0.5mg IM adrenaline
when can COCP be started after a C-section?
21 days (if not breastfeeding and no thrombo risk factors) need to wait 6 weeks if breastfeeding
when can POP be started after C-section?
immediately
management of heavy vaginal bleeding?
tranexamic acid
mefenamic acid (try to avoid if trying to conceive)
mirena coil (probs first choice if not wanting to conceive)
COCP
how is tranexamic acid taken?
take 1g 3X daily for 3-4 days during period
can ACEi be taken in pregnancy?
no
should change to methydopa/nifedipine/labetolol
can lithium be taken in pregnancy?
probs shouldnt be but dont come off it if thats the only thing that manages mental health
