Prescribing in Pregnancy Flashcards
how might drug absorption be affected in pregnancy
may be affected by morning sickness
how might drug distribution be affected in pregnancy
increased plasma volume + 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 e.g. phenytoin
Elimination of renal excreted drugs increases- due to increased GFR
What period is the fetus at greatest teratogenic risk
between 4th-11th week
why is the fetus at greatest risk during this time
organogenesis
list some teratogenic drugs
ACEi/ARB Androgens Anti-epileptics Cytotoxics Lithium Methotrexate Retinoids Warfarin
what does taking ACEi/ARB cause in pregnancy
renal hypoplasia
what does taking lithium in pregnancy cause
cardiovascular defects
what does taking methotrexate in pregnancy cause
skeletal defects
what anticoagulant does not cross the placenta
heparin
If a woman has frequent seizures in pregnancy, how might this affect the foetus?
Lower verbal IQ
Hypoxia
Bradycardia
Antenatal death
anti-epileptic drugs that should be avoided in pregnancy
valproate
phenytoin
is insulin safe in pregnancy?
Yes
which diabetes medication is not safe in pregnancy
sulfonylureas
BP medication safe in pregnancy
labetalol
methyldopa
treatment of nausea/vomiting in pregnancy
cyclizine
which antibiotic is NOT safe in pregnancy
gentamicin
Treatment of UTI in 1st + 2nd trimester
Nitrofurantoin or cefalexin
treatment of UTI in 3rd trimester
Trimethoprim
DVT prophylaxis
LMWH
What problem does taking amiodarone while breastfeeding cause
neonatal hypothyroidism
what problem does taking cytotoxics (e.g. azathioprine/methotrexate) while breastfeeding cause
bone marrow suppression
what problem does taking benzodiazepines while breastfeeding cause
drowsiness
what drug suppresses lactation
bromocriptine
antibiotic that causes staining of the bones + teeth in kids
tetracycline
anti-epileptic drug associated with clef palate
phenytoin
anti-epileptic drug associated with neural tube defects
valproate
examples of neural tube defects
spina bifida
anencephaly
which antibiotic causes grey baby syndrome
chloramphenicol
