Prescribing in Pregnancy Flashcards
What pregnancy related factors may influence pharmacokinetics?
Absorption:
morning sickness
Distribution:
increased PV and fat stores
decreased protein binding (so increased free drug)
Metabolism:
Increased liver metabolism
Elimination:
Increased GFR
When during pregnancy is the greatest teratogenic risk?
4th-11th week
What are the teratogenic effects of ACEis/ARBs?
Renal hypoplasia
What are the teratogenic effects of androgens?
Virilisation of female foetus
What are the teratogenic effects of antiepileptics?
Cardiac, facial, limb and neural tube defects
What are the teratogenic effects of cytotoxics?
Abortion + others
What are the teratogenic effects of lithium?
Cardiovascular
What are the teratogenic effects of methotrexate?
Skeletal
What are the teratogenic effects of retinoids?
Ear, cardiovascular and skeletal
What are the teratogenic effects of warfarin?
Limb and facial defects
What kinds of problems can occur to the foetus if affected by drugs in the 2nd and 3rd trimesters?
Growth problems
Intellectuel impairment
Behavioural abnormalities
If possible, which epileptic drugs should especially be avoided in pregnancy?
Valproate
Phenytoin
What preventative measures can be taken by pregnant women on anti-epileptics?
Folic acid 5mg daily
Which diabetic drug class is contraindicated in pregnancy?
Sulphonylureas
Which hypertensive drugs are generally used in pregnancy?
Labetalol
Methyldopa
Nifedipine MR