Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Obs and Gynae Y4 > 11. Prescribing in Pregnancy > Flashcards

11. Prescribing in Pregnancy Flashcards

(66 cards)

Start Studying
1
Q

Pharmacokinetics in pregnancy

A
  • Slow gastric emptying (reduced drug absorption)
  • Increased maternal plasma volume (low serum levels of drugs, reduced effect)
  • Increased maternal hepatic metabolism (reduced plasma drug levels)
  • Increased renal perfusion and drug elimination (drugs cleared by the kidneys quicker so its’ plasma levels drop)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pre-implantation period development:

A

2 weeks post conception – ‘All or none effect’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Embryonic period development:

A

3rd -7th week (Day 18-55) post conception – problems in organogenesis causing permanent anatomical defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Foetal period development

A

8th week post conception to birth – growth and functional maldevelopment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Shortly before term development:

A

Adverse effects on labour or neonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Drugs causing anatomical defects:

A

Alcohol, lithium, phenytoin, tetracycline, thalidomide, warfarin, isotretinoin, danazol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Phenytoin effect on foetus:

A
  • Cleft palate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Tetracycline

A
  • Teeth staining
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Thalidomide

A
  • Embryopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Folate antagonist drugs

A

Anticonvulsants, methotrexate, sulfasalazine,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Neural crest cell disruption drugs

A

Retinoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Oxidative stress-causing drugs

A

Thalidomide, anticonvulsants, anti-arrhythmic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Vascular disruption-causing drugs

A

Misoprostol, aspirin, ergotamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Receptor or Enzyme-mediated teratogenesis

A

NSAID, statins, ACE inhibitors, Angiotensin II receptor blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Drug abuse: tobacco

A
  • IUGR

- Placenta praevia, placental abruption, ectopic pregnancy, PPROM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Drug abuse alcohol

A
  • FAS (mental and growth retardation)

- Spontaneous miscarriage in 1st trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Drug abuse: cocaine

A
  • Vasoconstrictor

- Placental abruption, growth and mental retardation, spontaneous miscarriage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Drug abuse: heroin or opiates

A
  • Vasoconstrictor
  • Spontaneous miscarriage, growth retardation, placental abruption
  • Neonatal withdrawal symptoms
  • Respiratory depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Ecstasy and LSD:

A
  • No withdrawal but delayed neonatal development
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Anti-emetics in pregnancy:

A

Safe: Prochlorperazine, Ondansetron, Metoclopramide, Domperidone, Cyclizine
SE: drowsiness, muscle spasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Hyperemesis gravidarum treatment:

A

Anti-emetics + Thiamine 1.5mg OD + Prednisolone 16mg OD + Parental fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Antacids in pregnancy :

A

Simple (Ca, Mg, Aluminium)
H2 blockers: Cimetidine, Ranitidine
PPI: Omeprazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Analgesics in pregnancy:

A

Aspirin: safe, but not in late pregnancy – delays labour and increases haemorrhage risk
NSAIDs: avoid post 30/40 as causes PDA closure, necrotising enterocolitis and pulmonary hypertension in bebo. Postpartum Ibuprofen preferred than Diclofenac
Opioids: safe for short term/ or neonatal withdrawal – Codeine, Dihydrocodeine, Morphine, Pethidine, Fentanyl, Methadone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Laxatives in pregnancy:

A
  • Lactulose, Glycerine suppositories: not absorbed, safe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Laxatives to avoid in pregnancy:
Senna, bisacodyl (cause contractions), purgatives with Mg, Na – cause electrolyte imbalance
26
Antifungals in pregnancy:
Topical (safe as pessaries or creams): Clotrimazole, Econazole
27
Antifungals to avoid in pregnancy:
Systemic (hepatotoxic, teratogenic): Fluconazole, Griseofulvin, Terbinafine
28
Antibiotics in pregnancy:
Safe: Penicillins, Cephalosporins, Erythromycin, Metronidazole, Ethambutol, Isoniazid
29
Antibiotics to avoid in pregnancy:
Ototoxic: Streptomycin NTD, facial cleft: Rifampicin, Trimethoprim Arthropathy: Ciprofloxacin, Quinolones Cataract, dysplasia of bones, teeth staining: Tetracycline
30
Anticoagulants in pregnancy:
Heparin (unfractioned does not cross placenta) and LMWH safe
31
Anticoagulants to avoid in pregnancy:
DOAC – contraindicated, risk of bleeding
32
Warfarin in pregnancy:
- Teratogenic; not given in 1st trimester (blindness, mental retardation, midface hypoplasia) - 2nd and 3rd trimester: risk of placental/foetal haemorrhage
33
Anti-epileptic drugs in pregnancy:
Teratogenic/NTD, but Lamotrigine, Carbamazepine – safest.
34
Hypertension in pregnancy:
- B blockers (safe in 3rd trimester) - Methyldopa - Nifedipine - IV labetalol (avoid in asthma) or hydralazine - Magnesium sulphate
35
Hypertension in pregnancy – contraindicated treatments:
- ACE inhibitors and Angiotensin II receptor blockers (cross placenta: foetal hypotension, IUGR, renal dysgenesis, lung underdevelopment) - Diuretics
36
Diabetes in pregnancy:
Metformin and insulin – safe
37
Diabetes in pregnancy treatment to avoid:
- Sulphonylureas – foetal hyperinsulinemia and hypoglycaemia - Steroids avoided
38
Anaemia in pregnancy:
- Iron deficiency (6-180mg elemental iron) - Megaloblastic anaemia (400-500mcg folate) - Sickle cell (folate supplements and transfusion at 6 week intervals)
39
Thyroid disease in pregnancy:
Hypothyroid: levothyroxine safe Hyperthyroid: radioactive therapy is contraindicated; Carbimazole and propylthiouracil -> cross placenta so use lowest dose
40
Asthma in pregnancy:
Oral/IV corticosteroid + nebulised b2-agonist for exacerbations (Prednisolone preferred to corticosteroids for oral treatment)
41
Which vaccinations to avoid in pregnancy?
Live vaccines, rubella vaccine, MMR, Polio
42
Vaccines contraindicated in pregnancy:
``` o BCG vaccine o Measles vaccine o Rubella vaccine o Varicella vaccine o Vaccinia (pox) vaccine o HPV vaccine ```
43
Recommended vaccinations in pregnancy:
``` o Inactivated influenza vaccine o Pertussis vaccine o Inactivated polio vaccine o Diphtheria toxoid o Tetanus toxoid ```
44
Drugs to reduce vertical transmission in HIV:
- Zidovudine | - Combination ART (Tenofovir DF/ Abacavir + Emtricitabine / Lamivudine)
45
Pregnancy and HIV treatment:
Mother: combined ART (Tenofovir DF/ Abacavir + Emtricitabine / Lamivudine) Baby: Low risk: Zidovudine PO until 6 weeks old OR High risk: Combination PEP
46
Antipsychotics in pregnancy side effects:
GDM
47
Least toxic antipsychotics in pregnancy:
Haloperidol, Olanzapine, Quetiapine, Risperidone
48
TCAs in pregnancy side effects:
Imipramine: tachycardia, muscle spasms, respiratory distress
49
SSRI/SNRI in pregnancy side effects:
Anencephaly, cardiovascular malformations, neonatal hypoglycaemia, persistent pulmonary hypertension
50
Fluoxetine
51
Lithium in pregnancy:
Teratogenic, cardiac abnormalities, goitre, hypotonia, DI
52
Benzodiazepines in pregnancy:
Risk of cleft palate, neonatal withdrawal and hypotonia, and cardiac malformations
53
Mifepristone
Anti-progestogenic steroid, sensitises myometrium to PGs, induces contractions and dilates the cervix – used in TOP
54
Induction of labour drugs:
- Vaginal prostaglandin (PGE2 or Dinoprostone): to induce labour in women with ‘favourable cervix’ - Oxytocin (syntocinon) – slow IV infusion by syringe pump
55
Anaesthetic agents
- GA (Depress neonatal respiration if used in 3rd trimester) - Local anaesthetic (with large dose, respiratory depression, hypotonia, bradycardia) - Prilocaine and Procaine – neonatal methemoglobinemia
56
Tocolytics:
Uterine relaxants/Labour suppressants: Delay of uncomplicated premature labour between 24 and 33+6 gestational weeks with intact membranes
57
Contraindications for tocolytics:
- Cardiac disease, - Foetal death - Antepartum haemorrhage - Cord compression - Placenta praevia
58
Types of tocolytics:
- Oxitocin receptor antagonist | - Nifedipine
59
Ureterotonics:
Induce contraction or greater tonicity of the uterus. Used both to induce labour and to reduce postpartum haemorrhage
60
Indications for ureterotonics:
- Induction of labour - Management of 3rd stage of labour (prevention of PPH, uterine contractions post C-section) - Bleeding in spontaneous miscarriage
61
Mechanism of action of uterotonics:
Contractions of fundus by acting on local oxytocin receptors
62
Adverse effects of uterotonics:
Uterine spasm, nausea, vomiting, hypotension, tachycardia
63
Contraindications:
- Mechanical obstruction in pregnancy - Predisposition for uterine rupture - Foetal distress
64
Drugs to supress lactation:
- Cabergoline (same action, first line) | - Bromocriptine: dopamine receptor agonist (inhibits prolactin release)
65
Contraindications for lactation suppression drugs:
Hypersensitivity, hypertension, coronary artery disease, or mental disorders
66
Side effects of lactation suppression drugs:
Nausea, vomiting, constipation, headache, dizziness, postural hypotension, drowsiness, vasospasm

Obs and Gynae Y4 (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions