Pregnancy Flashcards
Benefits of prenatal supplements
- Help with fetal development
- Help prevent fetal complications
- Help prevent maternal complications
Prenatal supplements
- Folate: reduce risk of neural tubal defects
400-600 mcg - Calcium: decrease risk of maternal bone loss, HTN, preeclampsia
1000-1300 mg daily - Iron: helps with blood oxygenation
26-30 mg daily
Vaccine recommendations
Inactivated Flu before end of October
Tdap between 27-36 weeks of pregnancy
COVID 19
Vaccines to avoid during pregnancy
LIVE VACCINES
HPV
MMR
Live flu
Varicella
Yellow fever
Typhoid fever
Substance use
Alcohol use is NOT recommended during pregnancy
Fetal alcohol syndrome
central nervous system abnormalities
growth defects
facial dysmorphia
Tobacco and Marijuana
Low birth weight
Preterm birth
Birth defects
Death
Brain development disruption
Opioids
use during pregnancy has been linked to preterm birth, stillbirth, maternal mortality, feeding problems, breathing problems, and NAS
RISKS BENEFITS SITUATION
Medication use in pregnancy
What is the risk-benefit ratio?
Is the drug actually necessary?
What is the most effective agent and lowest effective dose with the lowest duration?
What would the health of the mother be without the drug?
Teratogenicity CONTRAINDICATED
- WARFARIN
- LISINOPRIL
- LITHIUM
- METHOTREXATE
- ALCOHOL
- ISOTRETINOIN
- STATINS
PK PARAMETERS
- Decreased rate of absorption
- Decreased protein binding
- Decreased CYP2C19 activity
- Increased CrCl
Package insert
section 8
Disease state management during pregnancy
Diabetes
Hypertension
Preferred treatment for diabetes
insulin for type 1 and 2
other oral options currently not recommended
monitor blood glucose 4 times daily
Preferred treatment for hypertension
Labetalol
Amlodipine
Nifedipine
HCTZ
Hydralazine
Methyldopa
AVOID MEDICATIONS ENDING IN PRIL AND SARTAN
Nausea and vomiting
usually in FIRST trimester
Risk factors motion sickness, GERD, high fat diet, younger
Non pharm and Pharm
First line treatment nausea and vomiting
Non pharm:
avoid triggers
eat smaller, dry meals
avoid spicy food
Second line treatment nause vomiting
Pharm:
1st- Pyridoxine
2nd- doxylamine and pyridoxine
3rd- meclizine, benadryl
last- zofran, metoclopramide
Treatment of UTI
Cephalosporins
Kflex
Amoxil
Ampicillin
Prevention of preterm labor
Progesterone
200 mg vaginal suppository if not history of preterm birth
250 mg IV weekly
Short-term complications in pregnancy
- nausea and vomiting
- heartburn and constipation
- Pain, fever, and headache
- cough and cold
- UTI
Pharmacological treatment of heartburn
- antacids (magnesium hydroxide, calcium carbonate)
- sucralfate: not absorbed in GI tract
- Histamine-2- receptor antagonists, proton pump inhibitor
Pharmacological treatment of constipation
osmotic laxatives (miralax, and lactulose)
stool softeners (docusate)
Bulk laxatives (psyllium)
Pharmacological treatment for pain, fever, and headache
- tylenol
AVOID NSAIDS AFTER 32 WEEKS
