Pregnancy, Breast Feeding, Children Flashcards
What are the effects of certain drugs in the first trimester?
Congenital effects
What are the effects of certain drugs in the second trimester?
Affect growth and development
What are the effects of certain drugs at term?
Obstetric complications and effects on baby
What are the common teratogenic drugs?
Methotrexate Trimethoprim Statins Tetracyclines Prostaglandin analogues, misoprostol ACEi/ARB Isotretinoin Lithium Sodium valproate Warfarin Chloramphenicol Aspirin/NSAIDS Topiramate Finasteride Quinolones Aminoglycosides
What are the common drugs affecting breast feeding?
Ethosuximide, lamotrigine - high amounts in breast milk
Fluvastatin - high amounts in breast milk
Phenobarbital - inhibits sucking reflex
Bromocriptine - inhibits lactation
What is the corrected gestational age?
Dose adjustments for premature baby
Corrected age = actual age in weeks - weeks premature
Do you need to adjust for hepatic impairment in children?
Normal no, as have large reserve of hepatic metabolic capacity
Why should you avoid benzyl alcohol in neonates?
Fatal toxic syndrome
Why should you avoid IM injections in children?
Painful
What are the pharmacokinetic interactions?
ADME
Absorption
Distribution
Metabolism
Excretion by kidneys
What are the general principles for mixing and compatibility in continuous subcutaneous infusions?
Injections give at separate sites and not mixed except syringe drivers
Prochlorperazine, chlorpromazine, diazepam are contraindicated due to injection site reactions
Injections dissolved in WFI are more painful
Physiological saline increases risk of precipitation when given with more than one drug
What drugs should not be mixed with diamorphine in continuous subcutaneous infusions?
Cyclizine- likely to precipitate
Haloperidol - likely to precipitate
What drugs can be used with diamorphine in continuous subcutaneous infusions?
Dexamethasone Hyoscine Levomepromazine Metoclopramide Midazolam
What are the IV infusions guidelines?
Add only one drug, components compatible Ready prepared when possible Do not add drugs to blood products Thoroughly mix Strict asepsis Label container Examine while running infusion
What are the common IV infusion incompatibilities?
Avoid precipitation - drugs that cause thrombophlebitis (diazepam) or extravasation (cytotoxics)
Don’t mix beta lactam antibiotics with proteinaceous materials
Loss of potency when added to large volume infusions
Common incompatible infusions - amino acids, mannitol, sodium bicarbonate
