obs drugs Flashcards
pregnacy hypothyroid
c) types and drug
b} maternal and fetal effects
a) m/c cause
c) known hypothyroid, first diag at preg - 2 types tsh incres
i- clinical / overt - t3t4 low
ii- subclincal - t3t4 normal
drug- thyroxine
b) maternal p4 pre eclampsia, placental abruption, preterm delivery, pph
fetal lbw, delay cogn devp, neurophysical impairment
a) hashimotos thyroiditis , iodine deficiency
TSH target levels
monitoring every _ weeks
a) normal
b) hypothyroid
c) hyperthyroid
iodine requirement
monitoring every 4 weeks
a)0.1-0.4
b)<2.5
c)0.1-0.2
250 mcg/day
fetal age or gest age for thyroxine production - starts, and detectable?
can t3t4 and tsh cross placenta
starts 12 weeks detectable 18-20 weeks
tsh no, t3t4 yes
DOC in hyperthyroidism
a) in 1st trims
b) 2nd and 3rd trim
c) thyroid storm
d) symp: tachycardia and tremors
e) gtd (increased hcg) with , without symptoms
a) PRO PYL THIO URACIL (PTU)
b) METHI MA ZOLE ( CARB I MAZOLE)
c) PROPYL THIO URACIL
d) e) PRO PRA NO LOL gtd with symptoms without no need
treatment of hyperthyroidism in preg
a) absolute c/i
b) when is thyroidectomy done
c) anti thyroid drugs
a) radioactive iodine
b) 2nd trimester - liver toxicitiy / non compl to drugs
c) carbimazole, methumazole, ptu
fetal effects : carbimazole > ptu
liver toxicity: cb < ptu
m/c side effects of carbimazole
APLASIA CUTIS, tracheoesp fistula, omphalocele, patent vitello intestinal duct
Prolatin
a) secrt by?
b) max level?
c) inhibited by who in pregn?
d) milk ejection hormone and side effect of the hormone
a) ant pit and decidua
b) pregn (not on lactation), post delivery fall by 50%
c) estrogen and progesterone
d) oxytocin and side eff: abdominal pain ( ut contraction)
prolactinoma
a) indications for treatment in non preg women
b) 1st line mgt
c) DOC in non pregn female
f) non pregn trying to conceive
d) in pregn / + visual symptoms
e) pregn + increased nausea and vomiting
g) asymptomatic
e) in breast feeding
a) size»_space; = neuro, visual sympt
hypogonadism - amenorrhea, oligiomen
galactorrhea, infertility
b) dopamine agonist drugs
c) e) CAB ER GO LINE
d) f) BROMO CRIP TINE
g) no treatment
e) no drugs
if visual symptoms => bromocriptine / cabergoline => stop breast feeding
antibiotics in pregn
c/i
a) throughtout pregnancy
b) 1st trimester
c) safe
a) aminoglycosides ( TANGS Tobramycin, Amikacin, Neomycin, Strptomicin) , fluoroquinolone ( ofl, cipro -oxacin), tetracycline
b) flucanozole, nitrofurantoin
c) (CAMP) CEPHALOSPORIN, AMOXICLAV, METRONIDAZOLE, PENCILLIN
DOC
a) trichomonas vaginitis
b) bacterial vaginosis
c) anaerobic infections
d) candidiasis
e) chlamydia
f) gohorrhea
a) b) c) metronidazole 600mg bd x 7 days
d) tropical IMI DA ZOLE p/v x 7 days
e) azithromycin 1g single dose
f) inj. cef tri axone 500mg im single dose
anticoagulant DOC non pregnt women
a) mechanical valve
b) prosthetic valve
a) WARFARIN + ASPIRIN (75mg p/o daily)
b) Aspirin daily
WARFARIN
a) teratogencity
b) guidelines for usage and monitor ?
a) warfarin embropathy
b) dose
< 5mg/day continue till 36 weeks
>5mg/day replace it with LMWH /UFH in t1 - monitor anti X a levels: 0.8-1.2 U/ml
anticoag
a)on day of delivery
b) postpartum
c) drug used postpartum
d) anaesthesia type
a) stop 6 hours prior
b) nvd 6 hr after, lscs 6-12 hrs after
c) reinitiate UFH (i/v) + WARFARIN => monitor INR 2.5-3.0 => stop UFH
d) GA / regional ( epidural C/I causes hematoma)
DOC to be given female on ANTICOAG at time of delivery + increased risk of bleeding
PRO T AMINE SULFATE
antiepileptics in preg ( most to least teratogenic)
VAL PRO IC ACID (most) > PHENY TOIN > PHENO BARBITONE , CAR BA ME ZA PINE > LEVE TIRA CET AM , LAMO TRI GINE (least)
