OBS and GYNY

Question 1

SE ondansetron in pregnancy on baby

Answer 1

cleft lip/palate if used in first trimester
talk to mum and wight risk and benefits

lots other drugs can use

Question 2

drugs treat nausea and vomiting in pregnancy

Answer 2

first line:
antihistmaines: cyclizine, promethazine

phenothiazines: prochlorperazine/ chlorpromazine

2nd line:
ondansetorn
metaclopramide / domperidone

Question 3

SE metaclopramide use more 5 days

Answer 3

extrapyramidal = restlessness, parkisnonsism,
= drug induced movement disorders

Question 4

When not give NSAIDs

Answer 4

PPH
- lost blood–> may have pre renal AKI
–> nsaids also affect platelts -= reduced- and if lost blood dont want this

Question 5

can this be given in breast feedign?
lamotrigine

Answer 5

yes- nearly all antiepliepti s can

Question 6

can this be given in breast feedign?
carbimazole

Answer 6

no
passes into milk

Question 7

can this be given in breast feedign?
diazepam

Answer 7

no
active metabolite can be transferred to the baby via breast milk. The half-life of this drug is long and therefore should be avoided during breastfeeding as it could elicit adverse effects such as lethargy and weight loss in infants.

Question 8

can this be given in breast feedign?
sulphonylureas

Answer 8

no
can cause hypoglycemia in baby

can be transferred to the baby via breast milk. Due to their severe hypoglycaemic effects, breastfeeding patients should avoid taking them.

Question 9

can this be given in breast feedign?
isotretinoin

Answer 9

no
unclear but advise is to avoid all ORAL retinoids in breastfeeding

Question 10

SSRI choice in breastfeeeing

Answer 10

sertraline
paroextine

Question 11

what diabetic drugs avoided in breast feeding

Answer 11

metformin is ok

Sulfonylureas (gliclazide) should be avoided when breastfeeding due to the theoretical risk of neonatal hypoglycaemia.

Exenatide, liraglutide, and sitagliptin should be avoided when breastfeeding.

Question 12

active management of 3rd stage drugs

Answer 12

oxytocin - use more. less n and v with it
ergometrine

Question 13

what drug use in active managemnt of 3rd stagewith pt with ht
which drug not use

Answer 13

dont use ergometrine if got hx of ht

Question 14

if low platelts (eg in HELLP/ idiopathic thrombocytopenia) what drugs need be aware of in active third stage

Answer 14

oxytocin- given IM and so can cause a haematoma

Question 15

medical mamagnemnt of PPH - esp if atony the cause

Answer 15

in this order:
bimanual uterine compression to manually stimulate contraction
intravenous oxytocin and/or ergometrine
intramuscular carboprost
intramyometrial carboprost
rectal misoprostol
surgical intervention such as balloon tamponade

Question 16

uterine atony first line meds

Answer 16

This states that first-line management should be 5U of IV Syntocinon (oxytocin), followed by 0.5 mg of ergometrine.

Question 17

medical treatment of pre ecampsia / eclampisa when to give magnesium sulphate

Answer 17

high risk severe pre eclampsia
eclampisa

give for 24 afters after delviery/ last seizure- whichever is later

Question 18

what hb evels give iron supplements in postpartum

Answer 18

decrease by 5 units on each ‘step’:

115 for non-pregnant women, 110 in early pregnancy, 105 in later pregnancy, and 100 after childbirth.

Question 19

uti ppost partum + breast feeding
what abx give

Answer 19

trimethoprim= 1st line in non preg + safe in pregnancy