PRESCRIBING IN PREGNANCY

Question 1

Which drugs do NOT cross the placenta?

Answer 1

insulin & heparinoids

Question 2

If exposed before 17 days (pre-embryonic), what is the outcome?

Answer 2

miscarriage

Question 3

If exposed 17-55 days (embryonic), what is the outcome?

Answer 3

disrupted organogenesis -> congenital malformation

Question 4

If exposed > 8 weeks GA (foetal), what is the outcome?

Answer 4

disrupted foetal growth & organ function

Question 5

NSAIDs in 1st trimester cause?

Answer 5

cleft palate

Question 6

NSAIDs in 2nd/3rd trimester cause?

Answer 6

renal dysfunction

Question 7

NSAIDs in the 3 trimester cause?

Answer 7

closure of ductus arteriosus

Question 8

maternal physiology related to pharmokinectics

Answer 8

increased plasma volume
decreased albumin
decreased hepatic metabolism
delayed gut function

Question 9

what types of drugs enters breastmilk?

Answer 9

lipophilic - e,g, citalopram (but not sertraline)

Question 10

what drugs do NOT pass into breast milk

Answer 10

heparin
insulin
warfarin (protein bound)

Question 11

which drugs to avoid during breastfeeding - name 13

Answer 11

lithium, benzodiazepines
methotrexate
carbimazole
cyclophosphamide, anti-neoplastics
aspirin
amiodarone/iodine
codeine/oxycodone
ciprofloxacin, tetracycline, sulphonamides
reduce caffeine intake

Question 12

which drugs can be given during breastfeeding - 14

Answer 12

penicillins, cephalosporins, trimethoprim
thyroxine
steroids
sodium valproate, carbamazepine
TCA, antipsychotics
salbutamol
beta blockers
warfarin, heparin
digoxin

Question 13

what drugs to AVOID during pregnancy - name 12

Answer 13

NOACs
methotrexate
warfarin
doxycycline
isoretinoin
PO fluconazole
phenytoin, sodium valproate, carbamazepine
antineoplastics
ACEi
statins