Pregnancy & Lactation

Question 1

Antibiotics in Pregnancy

Answer 1

CI:

1) Fluoroquinolones
2) Tetracyclines

UTI:

1) Nitrofurantoin & SMX/TMP
- Last Line in 1st trimester / CI @ last 2 weeks pregnancy

Vaginal Fungal:
1) Topical vaginal antifungal (AVOID fluconazole PO)

Question 2

Drugs Contraindicated in Pregnancy

Answer 2

Warfarin (unless mechanical heart valves)
ACEi/ARBs
Statins

Dihydroergotamine / Ergotamine

NSAIDs
Ribavirin
Valproic acid / Topiramate / Lithium
Paroxetine
Methotrexate

Question 3

Hyperthyroidism

Answer 3

1st Trimester = Propylthiouracil

2nd-3rd Trimester = Methimazole

Question 4

Morning Sickness / Nausea

Answer 4

1) Vit B6 (pyridoxine)
2) Doxylamine (Unisom)
3) Ginger

Question 5

Constipation

Answer 5

Fiber:

1) psyllium (Metamucil)
2) methylcellulose (Citrucel)

Question 6

Cough, Cold, Allergies

Answer 6

Allergies:
Cromolyn (DoC)
Budesonide (Rhinocort)
Beclomethasone (Beconase)

[1st Gen Antihistamines] Preferred
chlorpheniramine (DoC)
diphenhydramine

[2nd Gen Antihistamines]
loratadine
cetirizine

Question 7

Anticoagulation

Answer 7

LMWH > UFH

Warfarin (only in mechanical heart valves)

Question 8

Avoid these drugs in Lactation b/c excreted in Breastmilk

Answer 8

Codeine / Tramadol
Amphetamines
Lithium
Phenobarbital

Statins
Amiodarone
Ergotamines

Metronidazole (discard breastmilk for 24 hours)