Therapeutics - Drugs in Pregnancy 1

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  1. What is the abnormality, estimated risk and critical period for teratogenicity of Thalidomide?
    • Phocomelia
    • Critical Period: 1st tri
    • % risk: 30
  2. What is the abnormality, estimated risk and critical period for teratogenicity of Warfarin?
    • Fetal warfarin syndrome
    • Critical Period: 6-9 wk
    • % risk: 5-10
  3. What are the signs of fetal alcohol syndrome?
    • Small head circumference
    • Epicanthic folds
    • Short nose
    • Small midface
    • Low nasal bridge
    • Thin reddish upper lip
    • Short Palpebral fissures
  4. What are the suspected teratogens?
    • Benzodiazepines
    • Estrogens
    • Progestins
    • Quinolones
  5. What drugs cause adverse effects in pregnancy but are not teratogens?
    • Antithyroid drugs
    • Aminoglycosides
    • Aspirin
    • Barbiturates
    • Benzodiazepines
    • Beta-Blockers
    • Hypoglycemic
    • Caffeine
    • Chloramphenicol
    • Cocaine
    • Nicotine
    • NSAIDs
    • Oral hypoglycemic agents
    • PTU
    • Sulfonamides
    • Diuretics
    • Isoniazid
    • Narcotic analgesics
  6. What drugs are considered safe in pregnancy?
    • Acetaminophen
    • Cephalosporins
    • Corticosteroids
    • Docusate sodium
    • Erythromycin
    • Multiple vitaminsNarcotic analgesics
    • Penicillins
    • Phenothiazines
    • Thyroid hormones
    • Tricyclic antidepressants
  7. How can you treat Morning sickness non-pharmacologically?
    • Small, frequent meals high in carbohydrates
    • Limit spicy foods
    • Avoid nausea producing situations, smells etc.
    • Cracker at bedside
  8. What are the Pharmacologic Morning sickness treatments?
    • Pyridoxine (Vit B6)
    • Cyanocobalamin (Vit B12)
    • Antihistamines
    • Doxylamine
    • Meclizine
    • Dimehydrinate
    • Promethazine
    • Metoclopramide
    • Ondansetron
    • Ginger
    • ??? Corticosteroids (If very severe, Dexamethasone, Prednisolone)
    • Diclegis (FDA approved)
  9. What is the treatment for constipation in pregnancy?
    • Fluids
    • Physical exercise
    • High fiber foods
    • Bulk-forming laxatives
    • Stool softeners
    • Milk of magnesia
  10. What constipation treatments should not be used in pregnancy?
    • NO enemas or strong stimulant laxatives without MD approval
    • Lactulose, sorbitol, bisacodyl, Senna, CI: Castor and mineral oil
  11. How is GERD in pregnancy treated?
    • Small, frequent meals, no late night meals
    • ↓ Caffeine, nicotine, chocolate etc.
    • ↑ HOB or sleep on 2 pillows
    • Antacids for mild to moderate
    • Ranitidine (Zantac®)
    • Metoclopramide (Reglan®) for severe
    • PPIs
  12. What cannot be used for GERD in pregnancy?
    NO sodium bicarbonate without MD approval
  13. How is epilepsy treated in pregnancy?
    • Stop medications if seizure free for several years
    • Single drug therapy when possible
    • Folic acid supplementation 0.4 – 5 mg daily
    • Vitamin K 10 mg PO daily in the last month
    • Screen for neural tube defects with:
    • Carbamazepine (Tegretol®)
    • Divalproex sodium (Depacon®)
    • Valproic acid (Depakote®)
  14. What are the risk factors for GDM?
    • >30 years of age
    • Obese
    • Previous history
    • + family history
    • African, Hispanic, Native, Asian American
  15. What glucose levels indicate GDM?
    • FBS > 90 – 99
    • 1 hr post prandial > 140
    • 2 hr post prandial of >120 – 127
  16. What is the goal blood sugar for GDM?
    Maintain FBS 80 - 110 and 2 hr post prandial of <155
  17. What drugs are given in GDM?
    • Insulin
    • - Multiple daily insulin injections if necessary
    • - Split dosing with NPH and regular
    • Glyburide (May consider after 11 weeks gestation)
    • Metformin (Was used more commonly, but studies say that may cause pre-term baby)
  18. How is bacterial vaginosis treated in pregnancy?
    • Metronidazole:
    • - 500 mg po BID X 7 days
    • - 250 mg po TID X 7 days
    • OR
    • Clindamycin 300 mg po BID X 7 days
    • (don’t use vaginal preparations)
  19. How should HIV be treated in pregnancy?
    • ZVD after 14 wks gestation
    • Antepartum therapy and neonatal prophylaxis
    • ZVD drip (Retrovir®)
    • Nevirapine (Viramune®)
  20. How should HTN be treated in pregnancy?
    • Avoid ACEs, diuretics and ARBs
    • BBs are OK
  21. What drugs should you give for depression in pregnancy?
    • TCAs and SSRIs
    • Avoid Paxil
  22. What should you give patients with mood disorders during pregnancy?
    • ??? Lithium
    • Caution with valproic acid and carbamazepine
  23. How should HA be treated in pregnancy?
    • APAP, codeine, narcotics
    • NSAIDS (CI late in pregnancy)
    • Caffeine
    • ?Sumatriptan?
    • ?Beta Blockers?
  24. What should not be used to treat HA in pregnancy?
    CI – ergotamine and dihydroergotamine

Card Set Information

Author:
kyleannkelsey
ID:
293915
Filename:
Therapeutics - Drugs in Pregnancy 1
Updated:
2015-01-26 16:32:08
Tags:
Therapeutics Drugs Pregnancy
Folders:
Therapeutics - Drugs in Pregnancy
Description:
Therapeutics - Drugs in Pregnancy
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