Wk 12: Drug use in pregnancy Flashcards

1
Q

What are the pregnancy changes that occur in a mother?

A
  • Inc total body water
  • Inc liver metabolism
  • Inc renal blood flow
  • Inc plasma protein conc
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2
Q

What are the benefits to taking folic acid?

A
  • Prevents neural tube defects
  • 400 mcg daily, 5mg if high risk + vit D
  • 3 months before conception
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3
Q

What are the signs of fetal alcohol syndrome?

A
  • Flat midface
  • Thin upper lip
  • Short nose
  • Low nasal bridge
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4
Q

Which food must you avoid?

A
  • Vit A supplements/food high in vit A (liver/fish oil)
  • Unpasteurised milk + cheese
  • Ripened soft cheese
  • Raw/partially cooked egg
  • Caffeine
  • Seafood
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5
Q

Which vaccinations must you get and avoid during pregnancy?

A
  • Tdap - 27-36 weeks
  • Flu vaccine
  • Travel vaccine = avoid
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6
Q

Give examples of potential complications in pregnancy

A
  • VTE
  • HT
  • Preeclampsia
  • Gestational diabetes
  • Thyroid disorders
  • Anaemia
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7
Q

What are treatments for nausea + vomiting?

A
  • Ginger + wrist acupressure
  • Oral promethazine
  • Oral cyclizine
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8
Q

What is the extreme case of nausea + vomiting?

A

Hyperemesis gravidarum:

  • Severe vom
  • Dehydration + weight loss
  • Admission: fluid + electrolyte replacement, medication
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9
Q

Treatment for heart burn

A
  • 2nd line: Gaviscon + peptac

- 3rd: Ranitidine + omeprazole

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10
Q

What is the 1st and 2nd choice of laxatives for constipation?

A
  • 1st: bulk forming

- 2nd: lactulose/macrogol

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11
Q

Why is there an inc in urinary frequency when pregnant?

A
  • Hormone changes
  • Pressure on bladder from uterus
  • Relaxation of pelvic floor muscle
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12
Q

Why should trimethoprim be avoided in cases of a UTI?

A
  • Folate antagonist
  • Cardiovascular defects
  • Neural tube defects
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13
Q

What are alternative treatment options for UTI?

A
  • Nitrofurantoin: egrf >45, 50mg 4/day
  • Penecillin
  • Cephalosporins
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14
Q

Why does thrush occur during pregnancy + what medication can be taken?

A
  • Inc oestrogen level

- Topical clotrimazole

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15
Q

Why should NSAIDS be avoided during pregnancy?

A
  • Block blastocyst implantation
  • Persistent pulmonary HT of neonate (3rd trimester)
  • Inhibit labour
  • Cardiac defects
  • Cleft palates
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16
Q

What are signs of anaemia?

A
  • Shortness of breath
  • Poor conc
  • Poor appetite
  • Muscle weakness
17
Q

What are the monitoring requirements for anaemia?

A
  • Monitor Hb

Treat:

  • <11g/dl at booking
  • <10.5g/dl at 28 weeks
18
Q

What are the treatments available for anaemia?

A
  • Oral: ferrous sulphate 200mg TDS

- IV: Ferinject

19
Q

What are the treatments for VTE?

A
  • Tinzaparin
  • Dalteparin
  • Enoxaparin
  • Don’t use warfarin or DOACs
20
Q

Foetal warfarin syndrome

A
  • Nasal hypoplasia
  • Upper airway obstruction
  • Critical period 6-9 weeks
  • Risk of foetal + neonatal haemorrhage
21
Q

What are signs of gestational diabetes?

A
  • Inc thirst
  • Inc urinary freq
  • Dry mouth
  • Tiredness
22
Q

How do you manage gestational diabetes?

A
  • Diet + exercise
  • Metformin
  • Glibenclamide
  • Insulin
23
Q

What is gestational hypertension + when does it usually occur + treatment?

A
  • Sustained BP > 140/90mmHg in normotensive patient
  • 2nd half of pregnancy
  • Labetalol: 135/85
24
Q

What is pre-eclampsia?

A

High BP + proteinuria:

  • Weight gain >5 in a week
  • Headache
  • Swelling face