prescribing extreme ages Flashcards
fetal development
dysmorphic calendar
12-40 DAYS LIMB REDUCTION
24 DAYS ANENCEPHALY
34 DAYS TRANSPOSITION GREAT VESSELS
36 DAYS CLEFT LIP
42 DAYS VSD / SYNDACTYLY
84 DAYS HYPOSPADIAS
rugs in pregancy
ACE INHIBITORS - foetal or neonatal renal failure
ANTITHYROID DRUGS - foetal hypothyroidism
BENZODIAZEPINES - drug dependence
B-BLOCKERS - growth retardation
NSAIDs - constriction of ductus arteriosus
TETRACYCLINES - tooth discolouration
WARFARIN - foetal brain haemorrhage
OPIATES - drug withdrawal or respiratory depression in the neonate
AMIODARONE - foetal or neonatal hypothyroidism
BARBITURATES - dependency
drugs with good safety recored
Analgesics: paracetamol, codeine
Antacids: containing aluminium, calcium or magnesium
Antibiotics: cephalosporins, penicillins, erythromycin, clindamycin, nitrofurantoin (avoid near term)
Anti-emetics: cyclizine, promethazine
Antifungal agents (topical and vaginal): imidazoles (e.g. clotrimazole), nystatin
Antihistamines: chlorphenamine, hydroxyzine
Asthma: bronchodilator and steroid inhalers, a short course of oral corticosteroids
Corticosteroids: topical (including nasal)
Insulin: human
Laxatives: bulk-forming, lactulose
Levothyroxine
Methyldopa
Oral contraceptives: inadvertent use of normal doses in early pregnancy (including emergency hormonal contraception)
Ranitidine
Vaccines: inactivated
comonly used teratogeic medicines
PHENYTOIN
CARBAMAZEPINE
SODIUM VALPROATE
LITHIUM- risk teratogenicity, inc cardiac abnormalities
WARFARIN
RETINOIDS
DANAZOL- virilisation of female fetus
effects of drugs on the mother
CALCIUM ANTAGONIST - delay uterine contraction
MISOPROSTOL - promotes uterine contraction
NSAIDS - reduce uterine contraction
HEPARIN - maternal osteoporosis/ thrombocytopenia
maternal changes in [pregnancy
Increased blood volume of distribution
Decreased protein binding
Increased hepatic metabolism
Increased renal clearance