prescribing in pregnancy

Question 1

why avoid ACEi’s/ARBs

Answer 1

renal hypoplasia

Question 2

avoid androgens because

Answer 2

virilisation of female foetus

Question 3

avoid antiepileptics because

Answer 3

cardiac, facial, limb, neural tube defects

Question 4

avoid cytotoxics because

Answer 4

multiple defects, abortion

Question 5

lithium to be avoided because

Answer 5

cardiovascular defects

Question 6

methotrexate to be avoided in pregnancy because

Answer 6

skeletal defects

Question 7

warfarin can cause

Answer 7

limb and facial defects

Question 8

rentinoids can cause

Answer 8

ear, cardiovascular, skeletal defects

Question 9

what type of drugs can cross the placenta

Answer 9

LMW molecules

Question 10

pregnant woman with hypertension Tx

Answer 10

Labetalol/methyldopa

monitor in second semester as physiological changes could result in hypotension

Question 11

common OCPs to be avoided

Answer 11

St johns Wort
NSAIDs
other herbal medications

Question 12

child with dark staining of teeth

Answer 12

tetracyclines - must avoid during pregnancy and up to 10 years of childs life

Question 13

cause of kleft lip/palate

Answer 13

phenytoin

Question 14

vaginal adenocarcinoma cause

Answer 14

desplex

Question 15

spina bifida and “incomplete head”

Answer 15

valporate

Question 16

alcohol during pregnancy FAS signs

Answer 16

small head 
epicathal folds 
flat midface 
smooth philtrum 
underdeveloped jaw 
thin upper lip 
short nose 
small eye openings 
low nasal bridge

Question 17

drugs bad for labour

Answer 17

warfarin and opiates

Question 18

drugs bad for post labour

Answer 18

opiates and SSRIs

Question 19

Epilepsy meds and pregnancy

Answer 19

risk outweigh benefit?? 10% have an increase in seizures if stop taking

Question 20

diabetes and pregnancy

Answer 20

insulin is safe

sulfonylureas arent

Question 21

patient with nausea and vomiting tx

Answer 21

cyclizine

Question 22

patient with UTI tx

Answer 22

nitrofurantoin, cefalexin (3rd trimester - trimethoprim)`

Question 23

pain tx

Answer 23

paracetamol

Question 24

heartburn tx

Answer 24

antacids

Question 25

commonest cause of maternal death

Answer 25

VTE

Question 26

when to give prophylaxis of VTE

Answer 26

if 2 or more risk factors

Question 27

what is prophyaxis of VTE

Answer 27

a LMWH during delivery and up to 7 days later

Question 28

drugs likely to enter breast milk

Answer 28

small molecules that are fat soluble (lipophilic)

Question 29

foremilk is

Answer 29

protein rich milk

Question 30

hindmilk is

Answer 30

high in fat content

Question 31

phenobarbitone causes

Answer 31

suckling difficulties

Question 32

amiodarone causes

Answer 32

neonatal hypothyroidism

Question 33

cytotoxics cause

Answer 33

bone marrow suppression

Question 34

benzodiazepines cause

Answer 34

drowsiness

Question 35

bromocriptine causes

Answer 35

lactation suppression