Pregnancy Flashcards
What is the lab values that confirms pregnancy?
- High levels of human chorionic gonadotropin (hCG)
What are some of the vitamins and mineral supplementations that are important for a pregnant female to take for their baby?
- Folate 400 mcg (prevent neural tube defects)
- Calcium 1000mg/day & Vitamin D 600 IU/day (bone health)
- Iron 27 mg/day
Prenatal vitamins have a lot of this combined
What acne medicaitons are considered teratogenic?
- Isotretinoin
- Topical Retinoids
What antibiotic medicaitons are considered teratogenic?
- Quinolones
- Tetracyclines
What dyslipidemia, heart failure and hypertension medicaitons are considered teratogenic?
- Statins
- RAAS Inhibitors (ACEs, ARBs, ARNIs)
What hormone medicaitons are considered teratogenic?
- Estradiol
- Progesterone
- Raloxifene
- Duavee
- Testosterone
- Contraceptives
MOST
What are some other important medicaitons are considered teratogenic?
- Hydroxyurea
- Lithium
- Methotrexate
- Misoprostol
- NSAIDs
- Paroxetine
- Ribavirin
- Thalidomide
- Topiramate
- Weight loss drugs
- Valproic Acid/Divalproex
What is preeclampsia?
- elevated blood pressure during pregnancy that indicates organ damages (i.e.; kidneys or liver)
What is the recommendation to prevent preeclamsia?
- Low dose aspirin at the end of the first tri
What is the preferred management during preganancy for motion sickness, nausea, vomiting?
- Lifestyle changes first (avoid empty stomach, smaller meals, more meals, plenty of water…)
- Pyridoxine (Vit B6) +/- Doxylamine
What is the preferred management during preganancy for GERD/heartburn?
- Lifestyle changes first (smaller meals, more meals, avoid trigger foods, elevating head while sleeping…)
- Tums
What is the preferred management during preganancy for farting?
- Simethicone (GasX or Mylicon)
What is the preferred management during preganancy for constipation?
- Lifestyle changes first (more fluids, more fiber, more activity)
- Fiber (Psyllium, Calcium Polycarbophil) “Bulk Laxative”
What is the preferred management during preganancy for cough, cold, allergies?
- Cromolyn first line
- 2nd gen antihistamine (chlorpheniramine) second line [Loratidine or Cetirizine too]
- Nasal Steroids (budesonide) if needed
What is the preferred management during preganancy for pain?
- Tylenol first line [AVOID NSAIDs and Aspirin]
What is the preferred management during preganancy for asthma?
- Maintenacne: Busdesonide
- Rescue: ICS-Fomoteral or Albuterol
What is the preferred management during preganancy for Iron deficiency anemia?
- Iron or Prenatal vitamins with Iron
What is the preferred management during preganancy for hypertension?
- Labetalol, Nifedipine ER, Methyldopa
ACEs, ARBs, ARNIs are contraindicated
What is the preferred management during preganancy for Diabetes?
- Insulin when not controlled with lifestyle changes
- Low dose aspirin is recommended with preeclamsia in both T1 & 2 DM
What is the preferred management during preganancy for vaginal fungal infections?
- Topical Antifungals for 7 days
What is the preferred management during preganancy for Urinary Tract Infections?
- Cephalexin 500mg PO Q6H for 7 day
- Amoxicillin 500 mg PO Q8H for 7 days
- Nitrofurantoin, Bactrim are alternatives
What is the preferred management during preganancy for VTE?
- LMWH (Enoxaparin)
What is the preferred management during preganancy for Hypothyroidism?
- Levothyroxine (needs a 30 - 50% increase dose)
What is the preferred management during preganancy for hyperthyroidism?
- Mild cases no treatment
- If need drugs PTU during first tri
