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Repro HK > prescribing in pregnancy > Flashcards

prescribing in pregnancy Flashcards

1
Q

what drug does not cross placenta

A

low molecular weight heparin

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2
Q

what may affect absorption of drugs in pregnancy

A

morning sickness

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3
Q

why is distribution of drugs affected in pregnancy

A

increased plasma volume and fat stores

decreased protein binding - increased free drug

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4
Q

how is metabolism of drugs affected in pregnancy

A

increased liver metabolism (eg phenytoin)

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5
Q

how is elimination of drugs affected in pregnancy

A

elimination of renally excreted drugs increases (increased GFR)

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6
Q

what medication is recommended for 3 months prior to conception and for how long should it be continued

A

folic acid 400mcg/day

start 3 months before conception and continue for first 3 months of pregnancy

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7
Q

what does folic acid reduce risk of

A

neural tube defects

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8
Q

what drugs are teratogenic

A 
ACE inhibitors/ARBs 
androgens 
antiepileptics 
cytotoxic
llithium
methotrexate 
retinoids 
warfarin
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9
Q

what do ACE/ARBs cause

A

renal hypoplasia

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10
Q

what do androgens cause

A

virilisation of female foetus

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11
Q

what do antiepileptics cause

A

cardiac, facial, limb, neural tube defects

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12
Q

what does lithium cause

A

CV defects

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13
Q

what does methotrexate cause

A

skeletal defects

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14
Q

what do retinoids cause

A

ear, CV and skeletal defects

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15
Q

what does warfarin cause

A

limb and facial defects

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16
Q

what can opiates given during labour cause

A

respiratory depression

17
Q

what can SSRIs and opiates given throughout pregnancy cause

A

withdrawal symptoms

sedation

18
Q

complications of frequent maternal seizures

A 
lower IQ
hypoxia
bradycardia
antenatal death 
maternal death
19
Q

what anti-convulsants should be avoided in pregnancy

A

valproate

phenytoin

20
Q

what diabetic drug is not safe in pregnancy

A

sulfonylurea (convert these patients to insulin)

21
Q

what anti-emetic should be given in pregnancy

A

cyclizine

22
Q

what antibiotics should be used in pregnancy for UTI

A

nirofuratoin (1st and 2nd trimester)

trimethoprim (3rd trimester)

23
Q

what should be given for pain during pregnancy

A

paracetamol

24
Q

what should be given for heart burn during pregnancy

A

antacids

25
Q

criteria for prophylactic treatment of VTE during and after labour

A 
2 or more of: 
age >35
obesity 
smoking
parity >3
previous DVT 
C section
26
Q

what treatment is given prophylactically during labour and how long after birth should it be continued

A

LMWH

up to 7 days post partum

27
Q

what treatment is used if DVT/PE in pregnancy

A

LMWH

28
Q

what drugs are contraindicated in breastfeeding

A

amiodarone
cytotoxics
benzodiazepines
bromocriptine

Repro HK (37 decks)

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