Pregnancy

Question 1

What are the recommended pregnancy supplementation?

Answer 1

Folate 600 mcg/day
Calcium 1000 mg/day
Vitamin D

Question 2

What drugs are dangerous in pregnancy?

Answer 2

Isotretinoin
Quinolones, Tetracyclines
Warfarin
Statins
RAAS inhibitors
Hormones (SERMs, estrogen, or progesterone)
Migraine: ergotamine, dihydroergotamine
Hydroxyurea (SCD)
Methotrexate
Misoprostol
NSAIDs
Paroxetine
Ribavirin
Thalidomide
Toperamate
Valproic acid
Weight loss drugs

Question 3

Where can you check to see if a drug is safe in pregnancy or lactation?

Answer 3

Brigg’s Drugs

Question 4

What medication can you give a type 1 or type 2 diabetic pregnant women during her 1st trimester to prevent preeclampsia?

Answer 4

low-dose aspirin

Question 5

A pregnant patient is experience morning sickness. What are her options?

Answer 5

Lifestyle: eat smaller meals, drink water, avoid odorous foods, nap, reduce stress

If lifestyle fails, pyridozine (vitamin B6) with or without doxylamine

***Ginger may be beneficial

Question 6

A pregnant patient is experience GERD. What are her options?

Answer 6

Lifestyle: not eating 3 hours prior to sleep, avoid exacerbating foods, eat smaller meals

Tx: Tums

Question 7

A pregnant patient is experiencing fatulence. What are her options?

Answer 7

Simethicone

Question 8

A pregnant patient is experiencing constipation. What are her options?

Answer 8

Lifestlye: fluids, fiber, physical activity

Tx: fiber (bulk-forming) like -> psullium, calcium polycarbophil, methylcellulose

Question 9

A pregnant patient is experiencing cough and runny nose. What are her options?

Answer 9

1st: cromolyn
2nd: 1st gen antihistamines (Chlorpheniramine or Diphenhydramine)

***do NOT use oral decongestants or cough suppressants

Question 10

A pregnant patient is experiencing allergies. What are her options?

Answer 10

Budesonide (Rhinocort) or Beclomethasone (Beconase) nasal sprays

Question 11

What pain medication should you AVOID in pregancy?

Answer 11

NSAIDs
ASA
Opioids - last line

Question 12

What is the preferred treatment for asthma during pregnancy?

Answer 12

Budesonide (Pulmicort)
Albuterol

Question 13

What are the preferred treatment for HTN in pregnancy patients?

Answer 13

Labetalol
Methyldopa
Nifedipine

Question 14

What is the preferred treatment of diabetes in pregnant patients?

Answer 14

Insulin

**give low dose ASA to prevent pre-eclampsia in type 1 and type 2 patients

Question 15

What antifungals should you AVOID in pregnanct?

Answer 15

Fluconazole (DIflucan)

Question 16

What is the preferred treatment for UTI in pregnant women?

Answer 16

Cephalexin
Ampicillin

If in 1st trimester, last line bactrim or Macrobid

Question 17

During pregnancy what considerations do you have in women with hypothyroidism?

Answer 17

Pregnancy requires a HIGHER dose of levothyroxine (30-50% increase)

Question 18

If a pregnant patient has Grave’s disease, what is the recommendation?

Answer 18

1st trimester: Propylthiouracil

2nd-3rd trimester: usually switched to methimazole

Question 19

What supplementation is required during months 4-6 of an infants life?

Answer 19

Iron 1 mg/kg

Question 20

What pain medication should be avoided in lactating mothers?

Answer 20

Tramadol and Codeine
***breathing difficulty and death in infants!!!!

**use APAP or IBU

Question 21

For HIV mothers, is it safe to breastfeed their infant?

Answer 21

It is NOT recommend for HIV positive mothers too breastfeed their infant

Question 22

What medications should be avoided in breastfeeding mothers?

Answer 22

Amphetamine
Amiodarone
Ergotamines
Lithium
Metronidazole
Phenobarbital
Statins