3: Prescribing in pregnancy Flashcards Preview

Reproduction Week 5 2018/19 > 3: Prescribing in pregnancy > Flashcards

Flashcards in 3: Prescribing in pregnancy Deck (38)
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1

Which anti-emetic drug, given in the 1960s, causes birth defects?

Thalidomide

2

What is the rate of miscarriage in the general population?

25% of women will have a miscarriage during their lifetimes

3

Should pregnant woman not take any drugs?

Need to weigh benefits vs risks

4

What alternative therapies could you consider instead of prescribing a drug for a pregnant woman?

Physiotherapy

CBT

etc.

5

Most drugs (are / aren't) licensed for use in pregnant women.

aren't licensed

6

What are the principles of prescribing in pregnancy?

Benefit > Risk

Low dose monotherapy

Consider interactions

Consider breastfeeding

Avoid high risk drugs e.g warfarin

7

Does warfarin cross the placenta?

Yes

And it's teratogenic

8

Does heparin cross the placenta?

No

And it isn't teratogenic

9

What common condition in pregnancy may affect the absorption of a drug?

Morning sickness

10

Women tend to (gain / lose) weight during pregnancy.

gain weight

affecting the drug's volume of distribution

11

What doses of folic acid are given to

a) low risk

b) high risk

women before and during pregnancy?

a) 400 micrograms

b) 5 milligrams

12

Which cholesterol-lowering drugs cause birth defects?

Statins

13

What are some examples of chronic conditions which women may have before pregnancy?

Asthma

Epilepsy

Cardiovascular disease (e.g high cholesterol, HTN)

Diabetes

Rheumatoid arthritis

14

During which period is a foetus at greatest risk of harm from drugs?

1st trimester

0 - 12 weeks

15

At which point in gestation do women usually realise they're pregnant?

4 weeks

i.e they've been taking the teratogenic drug(s) without knowing they're pregnant

16

Which teratogenic drugs are used in hypertension and cause renal hypoplasia?

ACE inhibitors

ARBs

17

Which drug, used in RA, causes birth defects?

Methotrexate

18

Which drugs, used in severe acne, cause birth defects?

Retinoids

19

Which drugs cause respiratory depression and sedation in newborns?

Why might they be prescribed?

Opioids

Maternal pain relief

20

Apart from respiratory depression, what might be seen in newborn babies whose mothers have been taking opioids?

Withdrawal

21

Pregnancy and its associated symptoms can lower the ___ ___ in epilepsy.

seizure threshold

22

Which anti-epileptic drugs should be avoided in pregnancy?

Sodium valproate

Phenytoin - terminates status epilepticus

23

What dose of folic acid should a woman with epilepsy receive during pregnancy?

Why?

5 milligrams

All anti-epileptic drugs have possibility of causing neural tube defects

24

What percentage of women on anti-epileptics don't suffer foetal abnormalities?

96%

25

___ control of diabetes may cause birth defects.

Poor control

26

Which drug used in diabetes is contraindicated in pregnancy?

Sulphonylureas

so gliclazide

27

Which drugs, used in adult hypertension, should be avoided in pregnancy?

ACE inhibitors

ARBs

28

Which drugs are used to treat pregnancy-induced hypertension?

Methyldopa

Labetalol

Nifedipine

29

ACEIs and ARBs cause what kind of birth defect?

Renal hypoplasia / absence

30

Which anti-emetic is given first line for morning sickness?

Cyclizine