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What are examples of Rxs worse during the 2nd or 3rd trimester?
ACE inhibitors, ARBs
What Rx should be used in place of warfarin during pregnancy?
Heparin__large, ionized, does not cross placenta
What are the S/Sx of warfarin syndrome?
Saddle nose, short hands, ophthalmic problems, bone changes
What changes are seen c thalidomide teratogenesis?
Limb deformities (flipper limbs)
What is seen c phenytoin?
- Growth retardation, mental deficiency
- Short broad nose, cleft palate, abnormal genitalia, no fingernails/toenails
- Cardiac abnormalities
What changes were seen c DES use?
Vaginal and cervical adenocarcinoma showing up later
What is seen c sex hormone use in pregnancy?
- Vertebral: hypoplastic vertebrae
- Anal atresia
- Cardiac septal defects
- TracheoEsophageal fistulas
- Renal: poor development, inability to urinate
- Limbs: lower arm, thumb
What does category A mean?
Controlled human studies have demonstrated no fetal risk
What are the only 2 Rxs classified as category A?
Levothyroxine and folic acid
What does category B mean?
Animal studies indicate no risk OR adverse effects in animals, but not in human studies
What is category C?
No adequate human or animal studies OR adverse animal data, but no human data
When are category D Rxs used?
Only in life-threatening dz or where other Rxs carry a greater risk
What are the category X Rxs? [BOOM]
- Statins, warfarin
- Misoprostol, ergots
- Flurazepam, sex hormones (mifepristone, raloxifene, finasteride), leflunomide, EtOH, radioactive compounds