Pregnancy and Breastfeeding Flashcards
What common drugs are prescribed in pregnancy?
- For minor ailments: analgesics, antibiotics, migraine - strain on back, more prone to UTIs
- Pregnancy induced disorders: eg morning sickness
- Chronic problems: asthma, epilepsy, depression
Should drugs for chronic disorders be stopped?
No, disease may adversely affect pregnancy
What are some reasons a pregnant woman may stop copmplying with medications?
- doubt about drug use
- side effects
- disappearance of complaints for which drug was prescribed
What are some pre conception counselling points?
- recognise and address biomedical or behavioural issues that may pose a risk
- establish woman on prophylactic. drugs and immunisation
- ensure mother can make informed choices about therapeutic drugs
What is folic acid necessary for and what does deficiency cause?
- necessary for proper haematopoeisis
- deficiency leads to increased risk of neural tube defects
What is the risk of a NTD based on?
- either partner having a NTD, previous child with NTD, familt history of NTD
- woman taking anti-epileptic drug or diabetic
- BMI > 30kg/m2
If someone is at normal risk of NTD, how much folic acid should be prescribed?
400mcg daily until week 12 of pregnancy
How much folic acid should someone at high risk for NTD take?
5mg daily
What are some examples of enzymes inducers and how do they affect levonorgestrel?
- Antiepileptics - barbiturates, primidone, phenytoin, carbamazepine
- Anti-tuberculosis - rifampicin, rifabutin
- HIV medicines - ritonavir, efavirenz
- Antifungals - griseofulvin
- Herbal remedies containing St John’s Wort
Reduces plasma levonorgestrel con
What should women seeking emergency contraception be given?
Levonorgestrel: 1.5mg
If taking enzyme inducer: non-hormonal emergency contraceptive (copper intrauterine device) or double the dose to 3mg
How long does fetal development take?
40 weeks
What is a teratogen?
A substance, organisms, physical agents or deficiency capable of inducing abnormal structure of function such as:
- gross structural abnormalities
- functional deficiencies
- intrauterine growth restriction
- behavioural abberations
- demise
What is teratogenecity?
The potential for a drug to cause foetal malformations and affects the embryo 3-8 weeks after contraception.
These weeks are the period of highest risk as organ systems are formed
What % of birth defects do drugs account for?
2-3%
What can drugs during the 2nd and 3rd trimester affect?
growth (IUGR) and functional development or have toxic effects on tissues.
Adverse effects on neonate if given shortly before or during labour (eg diazepam). Mothers system metabolises drug, drug passes to baby