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Pharmacotherapy 2 - Final Exam > Pregnancy & Labor Study Guide > Flashcards

Pregnancy & Labor Study Guide Flashcards

1
Q

Folic Acid dose for pregnancy

A

400 mcg QD

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2
Q

Periods of high sensitivity for CNS

A

Gestation wk 3-6.6

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3
Q

Periods of high sensitivity for Heart

A

Gestation wk 3.5-6

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4
Q

Periods of high sensitivity for Ears

A

Gestation wk 4-9.5

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5
Q

Periods of high sensitivity for Eyes

A

Gestation wk 4-8.5

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6
Q

Periods of high sensitivity for Limbs

A

Gestation wk 4-7.5

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7
Q

Periods of high sensitivity for Teeth

A

Gestation wk 6.5-9

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8
Q

Periods of high sensitivity for Palate

A

Gestation wk 6.5-9

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9
Q

Periods of high sensitivity for External Genitalia

A

Gestation wk 7.5-10

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10
Q

Drugs with proven teratogenic effects

A

Organogenesis - Methotrexate; Lithium; Retinoids (Isotreninoin); Thalidomide; Antiepileptic drugs; Coumadin; Ergot alkaloids; Misoprostol (Cytotec); 2nd/3rd trimester - NSAIDs, tetracycline, ACE inhibitors

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11
Q

Teratogenic effect of Coumadin (Warfarin)

A

Fatal fetal hemorrhage

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12
Q

Teratogenic effect of Isotretinoin (Accutane)

A

Spontaneous abortion; premature birth; low IQ; Avoid preg 1 mo following cessation of tx

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13
Q

Teratogenic effects of Anti-Epileptics (Valproic acid; carbamazepine; dilantin)

A

Neural tube defects; continued monotherapy recommended for seizures but must take folic acid

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14
Q

Teratogenic effects of NSAIDs after wk 30

A

Premature closure of PDA, hemorrhage, necrotizing enterocolitis

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15
Q

Teratogenic effects of Lithium

A

Cardiac malformations in 1st trimester; monitoring during preg required

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16
Q

Teratogenic effects of Tetracyclines

A

Bone & teeth deformities

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17
Q

Teratogenic effects of ACE inhibitors

A

Decreased placental blood flow, LBW, Fetal HypoTN; Fetal death (most in 2nd/3rd trimester)

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18
Q

Preferred pain reliever/HA tx during pregnancy

A

Acetaminophen

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19
Q

1st line Heartburn Tx during Pregnancy

A

Calcium antacids (TUMS)

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20
Q

2nd line Heartburn Tx during Pregnancy

A

Ranitidine (Zantac)

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21
Q

Heartburn Tx to AVOID during Pregnancy

A

Aluminum hydroxides (Maalox; Mylanta) d/t fetal neurotoxicity

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22
Q

1st Line Constipation Tx during Pregnancy

A

Bulk-forming laxatives - Psyllium (Metamucil); Polycarbophil (Fibercon)

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23
Q

Constipation Tx to AVOID during Pregnancy

A

Magnesium-containing laxatives or phosphosoda d/t electrolyte disturbances; AVOID CASTOR OIL

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24
Q

1st Line N/V Tx during Pregnancy

A

Pyridoxine (B6); Doxylamine (Unisom); Ginger

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25
Q

2nd/3rd Line Constipation Tx during Pregnancy

A

Metoclopromide (Reglan)

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26
Q

URI Tx during Pregnancy

A

Afrin (PRN); Guaifenesin; Dextromethorophan

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27
Q

URI Tx to AVOID during Pregnancy

A

Pseudoephedrine, esp. in 1st trimester

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28
Q

Category B Antibiotics

A

PCNs; Cephalosporins; Azithromycin; Metronidazole

29
Q

Antibiotics to AVOID in Pregnancy

A

Bactrim; Aminoglycosides; Fluoroquinolones; Tetracyclines

30
Q

UTI Tx in Pregnancy

A

1st- Nitrofurantoin (Macrobid); 2nd - Cefpodoxime or Augmentin

31
Q

HTN Tx in Pregnancy

A

Methyldopa

32
Q

DM Tx in Pregnancy

A

Insulin only - NPH or Lantus

33
Q

Drugs with Absolute Contraindications during Lactation

A

Clomiphene; Ergots derivatives (bromocriptine; cabergoline; egotamine); Estrogens; Pseudoephedrine)

34
Q

Drugs requiring monitoring during Lactation

A

BBs; Amiodarone; Antineoplastics; Ergotamine; Illicit drugs; Lamotrigine; Lithium; Phenobarbital; Radioactive iodine; Tetracyclines

35
Q

Tocolytic Agent MoA

A

Decrease uterine contractions to prolong time to delivery

36
Q

Tocolytic Protocol

A

Delay delivery for 2-7 d for preterm labor beween 24-33 wk

37
Q

Avoid tocolytics

A

Intrauterine infxn; fetal distress; maternal hemodynamic instability; vaginal bleeding

38
Q

1st Line Tocolytics

A

Magnesium sulfate; Terbutaline (Brethine)

39
Q

2nd Line Tocolytics

A

Indomethacin; Nifedipine (Adalat; Procardia)

40
Q

Magnesium Sulfate MoA

A

Suppress contractions by antagonizing intracellular Ca in smooth muscles; Also used for seizure prophylaxis

41
Q

Magnesium Sulfate AE

A

Pulm edema; cardiac arrest

42
Q

Magnesium Sulfate Dosing

A

IV with loading dose with maintenance dosing; D/C after delaying delivery for 48 hr

43
Q

Terbutaline (Brethine) MoA

A

Decrease intracellular Ca & decrease contractile sensitivy to Ca

44
Q

Terbutaline (Brethine) AE

A

Maternal - Arrhythmias; tachycardia; Pulm edema; Fetal - Tachycardia; Blood glucose abnormalities

45
Q

Nifedipine (Adalat; Procardia) Advantage

A

Better neonatal outcomes & less maternal ADRs than other tocolytics

46
Q

Nifedipine (Adalat; Procardia) AE

A

HypoTN; flushing; edema; CHF; dizzy; HA

47
Q

Indomethacin Use

A

Tocolytic; closure of PDA

48
Q

Indomethacin MoA

A

Inhibits cervical prostaglandin activity

49
Q

Indomethacin AE

A

Neonatal complications - Necrotizing enterocolitis, hemorrhage

50
Q

Antenatal Glucocorticoid Use

A

Decrease complications associated w/ prematurity&raquo_space; Fetal lung maturation

51
Q

Antenatal Glucocorticoids

A

Betamethasone IM x 2d

52
Q

1st Line Group B Strep Tx in Pregnancy

A

PCN G

53
Q

Alternate Group B Strep Tx in Pregnancy

A

Ampicillin; Cefazolin

54
Q

PCN allergy - Group B Strep Tx in Pregnancy

A

Clindamycin or Erythromycin

55
Q

Cervical Ripening Agents

A

Dinoprostone (Cervidil); Misoprostol

56
Q

Misoprostol Contraindications

A

Patients with previous C-section (associated w/ uterine rupture)

57
Q

When to administer Oxytocin

A

Dinoprostone: 6-12 hr after cervical ripener; Misoprostol: 3 hr after cervical ripener

58
Q

Dinoprostone Uses

A

Labor induction; Cervical ripening; Pregnancy termination from 12-20 wk

59
Q

Dinoprostone Blackbox

A

Only to be used by medical providers at medical facility

60
Q

Oxytocin (Pitocin) Uses

A

Labor induction; Control postpartum bleeding

61
Q

Oxytocin (Pitocin) Contraindications

A

Fetal distress

62
Q

Vaginal Delivery Contraindications

A

Active genital herpes; Prolapsed cord; Total placenta previa

63
Q

Labor Analgesia

A

IM or IV Narcotics - Meperidine (Demerol); Morphine; Fentanyl (Duragesic)

64
Q

Methyldopa MoA

A

Stimulates alpha2-adrenergic receptors (centrally acting antihypertensive)

65
Q

Alternative HTN tx during Pregnancy

A

BBs & CCBs

66
Q

Seizure Prophylaxis in Pre-Eclampsia/Eclampsia

A

Magnesium sulfate

67
Q

BP control in Pre-Eclampsia/Eclampsia

A

Hydralazine (PO); Labetalol (IV)

68
Q

Metritis Tx

A

Cefotetan, or Cefoxitin, or Amp + AG; or Clinda + Gent

69
Q

Mastitis Tx

A

Dicloxacillin

Pharmacotherapy 2 - Final Exam (10 decks)

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