Prescribing in Pregnancy

Question 1

How might pharmacokinetics be affected by pregnancy?

Answer 1

Less absorption (morning sickness)
Increased plasma volume and fat
Increased metabolism
Decreased binding

Question 2

What should a female take 3 months prior to and in the first 3 months of pregnancy?

Answer 2

400 mcg folic acid

Question 3

In which trimester is a baby at most risk from teratogenicity?

Answer 3

1st trimester

Question 4

What teratogenic effect do ACEI/ARBs have?

Answer 4

Renal hypoplasia

Question 5

What teratogenic effect do antiepileptics have?

Answer 5

Cardiac defects
Facial and limb defects
Neural tube defects

Question 6

What teratogenic effect does lithium have?

Answer 6

Cardiac defects

Question 7

What teratogenic effect does methotrexate have?

Answer 7

Skeletal defects

Question 8

What teratogenic effect does warfarin have?

Answer 8

Limb and facial defects

Question 9

What are frequent seizures in pregnancy associated with in the child?

Answer 9

Lower IQ
Hypoxia
Bradycardia
Death

Question 10

Which antiepileptics should be avoided in pregnancy?

Answer 10

Valproate

Phenytoin

Question 11

Which class of diabetic drugs is not safe in pregnancy?

Answer 11

Sulfonylureas

Question 12

Which antihypertensives should be avoided in pregnancy?

Answer 12

ACEI/ARB

Question 13

Which drug is used to treat VTE in pregnancy?

Answer 13

LMW heparin

Question 14

List some common drugs that can concentrate in breastmilk and their effect

Answer 14

Phenobarbitone (suckling difficulty)
Amiodarone (hypothyroidism)
Cytotoxics (bone marrow suppression)
BZDs (drowsiness)
Bromocriptine (suppresses lactation)

Question 15

Which antibiotic given in pregnancy or early childhood can cause blue staining of teeth?

Answer 15

Tetracycline

Question 16

List facial features of foetal alcoholic syndrome

Answer 16

Short palpable fissures
Flat midface
Epicanthal folds
Short nose, low bridge
Indistinct philtrum
Thin upper lip

Question 17

Which antiepileptic can cause cleft lip/palate?

Answer 17

Phenytoin

Question 18

Which antiepileptic is associated with neural tube defects?

Answer 18

Valproate