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Phar 508 > Pregnancy and Lactation > Flashcards

Pregnancy and Lactation Flashcards

1
Q

Where does fertilization occur, when does the fertilized egg reach the uterus, when does implantation occur

A

Fallopian tubes, Day 3, Day 8-10

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2
Q

What is used to diagnose pregnancy, what produces it, what is used to test for active pregnancy

A

Human chorionic gonadotropin (hCG), placenta, Beta-subunit of hCG

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3
Q

T/F: Preganancy tests are usually 97% accurate and usually false negatives because patients are testing to early

A

True

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4
Q

When is the highest amount of drug exposure of the fetus

A

The first trimester

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5
Q

What is gravidity and Parity

A

Gravidity= total number of pregnancies, parity= deliveries

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6
Q

What are the types of delieveries

A

T: term (greater than 37 weeks), P: preterm (20-37 weeks), A: abortion/ectopic, L: living children

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7
Q

T/F: If a patient is currently pregnant the Gravidity is always higher than the Parity

A

True

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8
Q

Which CYP enzymes are increased during pregnancy

A

3A4 and 2D6

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9
Q

How does drug transfer occur in placenta

A

Simple diffusion

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10
Q

What is the most common reasons for congenital defects

A

Idiopathic (spontaneous), genetic

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11
Q

In the old FDA system what did the categoes A-X mean

A

A: well controlled, no risk
B: less controlled, no risk
C: unknown risk
D: known risk but benefit may be greater than risk
X: Known risk and risk is greater than the benefit

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12
Q

In the new FDA system what changed

A

There are categories for pregnancy (trimesters), lactation, and fertility

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13
Q

If a patient is pregnant what should be done if they are taking AEDs, such as cabamazepine

A

Give the lowest dose possible instead of switching to an alternative agent

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14
Q

What program is used to prevent isotrentinoin from causing harm to pregancy

A

REMS program

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15
Q

What blood thinner is known to cause teratogenic effects, what should it be switched to

A

Warfarin, LMWH

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16
Q

T/F: If a woman is pregnant than can drink alcohol as long as it is a tiny amount

A

False: Drinking while prenant increases the risk of defects regardless of the amount

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17
Q

What vitamins and nutrients should pregnant women be consuming

A

Iron 30 mg (2nd and 3rd trimester)
Folate 0.4mg/day, 4mg/day if history of tube defects or taking epilepsy meds
Calcium 1000-1200 mg per day

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18
Q

For acute pain what pharmacological agents should be used

A

Acetaminophen, Fioricet, Hydrocodone plus APAP (short term)

19
Q

What drug used for pain should not be used in the 2nd or 3rd trimester of pregnancy

A

NSAIDs

20
Q

What antimigraine drug has limited use

A

Triptans

21
Q

T/F: If a patient is pregnant with pain non-pharmacological options are preferred first

A

True

22
Q

How often does nausea/vomiting occur in pregnancies, when does it mostly occur

A

50-90% of pregnancies, 1st trimester peaking between weeks 8 and 12

23
Q

What pharmacological drugs are used for nausea and vomiting if it is mild

A

Pyroxidine (B6), Doxylamine, Diclegis (doxylamine/pyridoxine)

24
Q

What pharmacological drugs are used for moderate nausea and vomitting, tips

A

Metoclopramide (Do not use more than 12 weeks)
Promethazine (suppository if needed)
Prochlorperazine (suppository if needed)

25
Q

What pharmacological drugs is used for severe nausea and vomiting,tip

A

Ondansetron (but only in the 2nd or 3rd trimester)

26
Q

What is non-pharmacological management for GERD in pregnant patients

A 
Trigger avoidance
Avoid caffeine and nicotine
Elevate head of bed if symptoms at night
Avoid tight clothing
Smaller, more frequent meals
27
Q

What is the 1st line, 2nd line, and 3rd line of drugs used to treat GERD in pregnant patients

A

Antacids (avoid Mg in late pregnancy), H2RA: famotidine and ranitidine OR metoclopramide, PPIs (omeperazole doesn’t have to much data on it)

28
Q

What medication choice should be avoided in women with GERD, why

A

Sodium bicarbonate, increased risk of fluid/electrolyte imbalance in mother and fetus

29
Q

What are non pharmacological options for treat constipation in pregnant patients

A

High fiber foods, increased fluid intake, decrease caffeine, moderate exercise

30
Q

What are non pharmacological options to treat diarrhea

A

Keep hydrated, correct electrolytes

31
Q

What are the first line drugs for constipation in pregnant patients

A

Bulk forming laxatives, PEG, Docusate

32
Q

What are the second line drugs for constipation in pregnant patients

A

Senna, bisacodyl, lactulose

33
Q

What medications should be avoided if treating constipation in someone who is pregnant

A

Castor oil and Mineral oil

34
Q

What medications should be used to treat diarrhea in pregnant patients, avoided

A

Bulk forming laxatives and loperamide/ Bismuth sabsalicylate and diphenoxylate atropine

35
Q

T/F: If there is no pain from constipation then pharmacological options are still highly ranked

A

False: If there is no pain or blood there is no need to use medications for constipation in a pregnant patient

36
Q

What drugs are used for cough in pregnant patients

A

Guanifenisan +/- dextromethorphan

37
Q

What are the deconestants that can be used in pregnant patients, which cant and why

A

Salin nasal spray or topical decongestants, pesudoephedrine or phenlyephyine because the can reduce blood flow to the fetus

38
Q

What are the 1st and 2nd line options for allergies

A

topical nasal steroids (budesonide), 2nd generation histamines/ diphenhydramine or fexofenadine

39
Q

If someone has asymptomatic bacteria when are they tested for it

A

First trimester

40
Q

What antibiotics are used during pregnancy , which should be avoided in the 1st trimester

A

Nitrofurantoin, Beta lactams, and Bactrim/ Bactrim and Nitrofuratoin

41
Q

When are are women screened for group B strep during pregnancy, how is it treated

A

3rd trimester/ amoxicillin, penicillin and cephalexin

42
Q

T/F; Gummy multivitamins are sufficient for pregnant patiens

A

False: no iron is in gummy patients

43
Q

T/F: All pregnant patients should recieve the flu vaccine but no live vaccines

A

True

Phar 508 (21 decks)

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