Prescribing in Pregnancy Flashcards
what drug does not cross the placenta
Heparin
how might absorption be affected in pregnancy
may be affected by morning sickness
how might distribution be affected in pregnancy
increased plasma volume and fat stores
- volume of distribution increases
what other changes in pharmacokinetics are seen in pregnancy
Decreased protein binding
- Increased free drug
Increased liver metabolism of some drugs i.e. Phenytoin
Elimination of renally excreted drugs increases
- Increased GFR
what period is the foetus at greatest teratogenic risk
between 4th and 11th week
why is the foetus at a great teratogenic risk during this time
organogenesis
- product of organs
what are some teratogenic drugs
ACEi/ARB Androgens Anti-epilpetics Cytotoxics Lithium Methotrexate Retinoids Warfarin
what does taking ACEi/ARB cause in pregnancy
renal hypoplasia
what are frequent seizures during pregnancy associated with
lower verbal IQ in child, hypoxia, bradycardia, antenatal death, maternal death
what drugs should be avoided when treating epilepsy in pregnancy
valproate
phenytoin
what drug used to treat diabetes is not safe to use during pregnancy
Sulfonylureas
- convert to insulin
Tx for nausea and vomiting
cyclizine
what antibiotic cannot be used in pregnancy
gentamicin
what is prophylaxis for DVT
LMWH
what drugs cause problems via breastfeeding
Amiodarone – neonatal hypothyroidism
Cytotoxics – bone marrow suppression
Benzodiazepines – drowsiness
