Pregnancy

Question 1

Pregnancy Classification

• A
• B
• C
• D
• X

Answer 1

A
- Well controlled human study

B

• Animal studies: no risk
• Human studies: inadequate or animal studies show some risk

C

• Animal studies: some risk
• Human studies: inadequate or lacking

D

• Human studies: definite fetal abnomalities
• Potential benefits may outweigh the risks

X
- CI due to fetal abnormalities

Question 2

Management of N/V

Answer 2

• No large meals, no spicy food
• Have small, frequent, bland diet meals
• Vit B6 (Pyridoxime) IM or PO
• OTC benadryl or dramamine (preg cat B)
• 5HT3 inhibitors:
  Ondansetron (Zofran)
  Dolasetron (Anzemet)
  Granisetron (Kytril)
  Palonosetron (Aloxil)

Question 3

Management of low back pain, HA

Answer 3

• Tylenol is DOC
• NSAIDs:
  Cat B: in 1 and 2 trimester
  Cat D: in 3 trimester

Question 4

GERD management in pregnancy

Answer 4

Lifestyle/dietary modification

• Small meals
• No acidic foods
• No food 3H b/4 sleep
• Elevate head of bed
• Antacids: alginate
• H2 antagonist
• PPI
  Cat B except Prilosec (Cat C)

Question 5

Constipation in Pregnancy

Answer 5

• Fluid and fiber intake
• Milk of Magnesium
• Senna and Bisacodyl (Duclolax): Preg Cat C

Question 6

Pregnancy Rhinitis

Answer 6

• Saline nasal spray (Cat A)
• Antihistamine: Cat B
• Nasal decongestions: Afrin, Neo-Synephrine (Cat C)

Question 7

UTI during pregnancy

Answer 7

Macrobid (Cat B)
- CI in near term (38-42 wks), during labor and delivery

Near term

• Keflex PO for UTI
• Pyelonephritis: Ancef, Rocephin IV
• Bactrim, Quinolones: Preg cat C

Question 8

Preeclampsia

Eclampsia

Answer 8

• Cure: deliver ASAP
• If not: Mg sulfate IV to prevent sz
  Watch for resp depression

Question 9

Zofran

Answer 9

Odansertron

Question 10

Anzemet

Answer 10

Dolasetron

Question 11

Kytril

Answer 11

Granisetron

Question 12

Aloxil

Answer 12

Palonosetron