Pregnancy and Breastfeeding

Question 1

Drugs which SHOULD NOT be taken in pregnancy

Answer 1

oral isotretinoin
sodium valproate
ACE-I
Warfarin
NSAIDs

Question 2

Safe in epilepsy

Answer 2

levetiracetam, lamotrigine, carbamazepine

Question 3

safe in HTN

Answer 3

labetalol 100mg bd
methyldopa, nifedipine
aspirin 75mg from 12 weeks to birth
monitor BP 1-2x week

Question 4

Diabetes

Answer 4

Gestational - metformin 500mg BD
T1D - insulin, sliding scale if poor control
Sulfonylureas NOT RECOMMENDED

Question 5

Depression

Answer 5

Fluoxetine, Citalopram (concerns about QT) TCA

none licensed

Question 6

Effects of sodium valproate

Answer 6

10% risk of spina bifida
30-40% chance of delayed development
low intellect, poor language and memory

Question 7

Alternative - warfarin

Answer 7

LMWH

Question 8

Literature available

Answer 8

BNF
SPC
online CKS
Stockleys
Hospital MI

Question 9

Hayfever

Answer 9

loratadine most evidence but not enough to confirm safety
manufacturers do not recommend
Nasal steroids, sodium cromoglicate nasal spray or eye drops

Question 10

Indigestion - safe to give

Answer 10

gaviscon, antacids, calcium carbonate, magnesium hydroxide

Question 11

constipation

Answer 11

lactulose

Question 12

sore throat

Answer 12

can’t give benzydamine

Question 13

Flu jab

Answer 13

inactivated recommended

Question 14

Avoid in breastfeeding?

Answer 14

tramadol, aspirin, tetracyclines, quinolones, diazepam, atenolol, carbamazepine (this is maybe okay)