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Victor BNF Notes > Prescribing in Pregnancy, Breastfeeding and Children > Flashcards

Prescribing in Pregnancy, Breastfeeding and Children Flashcards

1
Q

What drugs are teratogenic (birth abnormalities)

A
  • Methotrexate, Trimethoprim
  • Statins
  • ACE Inhibitors / ARBs
  • Lithium
  • Sodium Valproate
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2
Q

What drugs cause dental hypoplasia and teeth staining in babies

A

Tetracyclines

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3
Q

What drugs can cause a miscarriage

A

Prostoglandin Analogues
e.g Misoprostol

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4
Q

What drug can cause congenital malformations and foetal haemorrhage

A

Warfarin

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5
Q

What drug can causes grey baby syndrome

A

Chloramphenicol

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6
Q

What is grey baby syndrome

A
  • grey skin
  • haemodynamic collapse
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7
Q

What drugs can cause early closure of ductus arterious in babies

A
  • Aspirin
  • NSAIDs
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8
Q

What drug causes a cleft plate in babies

A

Topiramate

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9
Q

What is cleft plate in babies

A

opening in roof of mouth

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10
Q

What drug can cause the feminisation of a male foetus

A

Finasteride

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11
Q

What drug can cause arthropathy in babies

A

Quinolones

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12
Q

What is arthopathy and what can it be associated with

A

It is a joint disease and it is associated with Lyme disease

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13
Q

What is Lyme Disease

A

a form of arthritis caused by bacteria that are transmitted by ticks.

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14
Q

What drugs cause auditory and vestibular damage in the 2nd and 3rd trimester

A

Amino glycosides

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15
Q

What medications stay in high amounts in breast milk

A
  • Ethosuximide
  • Lamotrigine
  • Fluvastatin
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16
Q

What drug inhibits infant’s suckling reflex

A

Phenobarbital

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17
Q

What drug inhibits lactation (breast milk production)

A

Bromocriptine

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18
Q

What is a pre-term neonate

A

baby born <37 weeks

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19
Q

What is a term neonate

A

baby born between 37 and 42 weeks

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20
Q

What is a post-term neonate

A

> =42 weeks

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21
Q

What is a neonate

A

0 to 28 days old

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22
Q

What is an infant

A

28 days to 24 months

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23
Q

What is a child

A

2 years till 12 years

24
Q

Children and hepatic impairment

A
  • children have a large reserve of hepatic metabolism
  • don’t need dose adjustments usually
25
Q

At which age are liver enzymes still immature

A
  • preterm neonate
    to
  • Infant
25
Q

How to calculate neonate eGFR

A

serum creatinine

26
Q

How to calculate child over 1 year eGFR

A

serum creatinine

27
Q

Why should you avoid intramuscular injections in children

A

it is painful

28
Q

What can benzyl alcohol do in neonates

A

fata toxic syndrome

29
Q

Why should you avoid lactose in medication

A

if severe lactose intolerance

30
Q

What can polyoxyl castor oil do in children

A

cause anaphylaxis

31
Q

If propylene glycerol is not eliminated from the body correctly, it can cause what

A

adverse effects

32
Q

What should you stick with when prescribing biosimilar medication

A
  • prescribe by brand name
  • do not switch brand
33
Q

How should multiple injections be administered

A
  • separate sites
  • not mixed

Except when using syringe drivers in palliative care

34
Q

What type of injection is more painful

A

one mixed with water for injection (isotonic)

35
Q

What drugs have injection site reactions together

A
  • prochlorperazine
  • chlorpromazine
  • diazepam
36
Q

The risk of what increases when giving more than one drug with saline solution or NaCl 0.9% solution

A

increases risk of precipitation

37
Q

When does IV Cyclizine precipitate when mixed with diamorphine

A
  • At a concentration >10mg/ml
  • When conc of diamorphine to cyclizine increases
38
Q

How quickly are mixtures of diamorphine and cyclizine precipitate

A

after 24 hours

39
Q

How quickly are mixtures of diamorphine and Haloperidol precipitate and at which concentration of haloperidol

A
  • after 24 hours
  • at a haloperidol concentration of >2mg/ml
40
Q

What medications can be mixed with diamorphine

A
  • cyclizine
  • haloperidol
  • dexamethasone
  • hyoscine
  • levomepromazine
  • metoclopramide
  • midazolam
41
Q

Problems with intravenous infusions

A
  • microbial contamination
  • Incompatibility
    (increases toxicity and side effects)
42
Q

What is incompatibility in IV fusions

A
  • wrong pH
  • concentration change
  • ‘salt out’ (where addition of salts causes crystallisation or precipitation)
43
Q

Why is precipitation in IV fusions bad

A
  • no control over dose
  • can initiate or exacerbate adverse effects
44
Q

Specifically what drugs and why should you avoid IV precipitations

A
  • Diazepam
  • Cytotoxics

you should avoid it as these drugs cause thrombophlebitis
(inflammation of vein wall)

45
Q

Which substances are commonly incompatible as IV fusions

A
  • Amino Acids
  • Mannitol
  • Sodium Bicarbonate
46
Q

Why should you not inject into blood

A

because it can cause irreversible crenation of red blood cells

47
Q

Why should you change the infusion administering set after giving the infusion

A
  • avoid contamination
  • avoid blood clot

(clotting factors from previous injection can cause a clot to form in the set.
-increases chance of microbial growth
- increase chance of embolisms)

48
Q

Why should you not add antibiotics or electrolytes to infusion sets

A
  • precipitation
  • break down of emulsion, causing a separation of phases. increases likely hood of embolism.
49
Q

Why should extemporaneous formulations should be made immediately

A
  • minimise microbial contamination
  • prevents degradation
50
Q

What does degraded ampicillin injection form if newly made and left.

A
  • forms polymers
  • which can cause sensitivity reactions
51
Q

Intravenous infusions things to make sure are done

A
  • use infusion fluid of correct pH with some drugs
  • mix drug additions well
  • ensure it is a quick process from adding mixing the infusion and administering
  • protect some injections from light
52
Q

Give an example of a drug that requires a specific pH when given in infusions

A

furosemide

53
Q

Why do you need to protect some infusions from the light

A

to prevent oxidation

54
Q

How is a continuous infusion diluted and set

A
  • diluted in large volume
  • infused over long time
55
Q

How is a intermintant infusion diluted and set

A
  • diluted in small volume
  • infused over short time
56
Q

How would you minimise extravasation with cytotoxic drugs in infusion

A
  • infuse via the drip tubing

Victor BNF Notes (25 decks)

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