Prescribing in Pregnancy

Question 1

What drugs cross the placenta?

Answer 1

small molecule ones - i.e. NOT HEPARIN

Question 2

How does the absorption of drugs differ in pregnancy?

Answer 2

affected by morning sickness

Question 3

How does the volume of distribution of drugs differ in pregnancy?

Answer 3

increases due to increased plasma volume and fat stores

Question 4

How does the free drug levels differ in pregnancy?

Answer 4

increased due to decreased protein binding

Question 5

How does the elimination of drugs differ in pregnancy?

Answer 5

increases due to increased GFR

Question 6

What is the period of greatest teratogenic risk?

Answer 6

4-11th week

Question 7

What should be given to pregnant women with epilepsy?

Answer 7

folic acid 5mg

monotherapy - avoid valporate or phenytoin

Question 8

What treatment is not safe in diabetic pregnant women?

Answer 8

sulfonureas

Question 9

What hypertension drugs should be used in pregnancy?

Answer 9

lebetalol
methyldopa
nifedipine

Question 10

How is nausea and vomiting treated in pregnancy?

Answer 10

cyclizine

Question 11

Do drugs enter the breast milk?

Answer 11

YES

Question 12

How do the foremilk and hindmilk differ?

Answer 12

foremilk = protein rich
hindmilk = higher fat content

Question 13

What does bromocriptine do to breast milk?

Answer 13

surpresses lactation

Question 14

What does benzodiazepines do to babies when in breast milk?

Answer 14

cause drowsiness

Question 15

What does amiodarone do to babies when in breast milk?

Answer 15

cause neonatal hypothyroidism