8 - Pregnancy

Question 1

Nausea in pregnancy non pharm

Answer 1

Ginger
Pyridoxinine (b-6)
Some other stuff that she will refuse to try

Question 2

Persistent N/V in pregnancy options

Answer 2

1st gen histamine blockers
Dopamine antagonist
Serotonin antagonist
Glucocorticoids

Question 3

What needs to be done when giving Histamine blockers to pregnant women?

Answer 3

D/C doxylamine (sleep aid) prior to starting

Question 4

What are the preferred pregnancy 1st gen histamine blockers?

Answer 4

Meclazine

Dyphenhydramine

Question 5

What are the preferred dopamine antagonist for n/v?

What are some problems with them?

Answer 5

Metoclopromide: tardive dyskenesia and dystonia

Promethazine: lower’s seizure threshold

Prochloperazine: case reports of malformations in infants

Question 6

What are the serotonin antagonist preferred for pregnancy?

What side effects do they have?

Answer 6

Odnasetron: may cause septum defects, miscarriage, low birth wt

Granisetron: no pregnancy studies conducted

Question 7

When are glucocorticoids safe to use in pregnancy for refractory n/v?

Answer 7

Only use short term and in the 2nd and 3rd trimester

Question 8

What can pregnant women take for reflux?

Answer 8

Antacids
Sucralfate
H2 antagonist
PPI’s

Question 9

What reflux med is never safe for pregnant women

Answer 9

Bismuth subsalicylate

Question 10

Ranitidine and cimetidine in nursing?

Answer 10

They excrete in the milk but are considered safe to use

Question 11

What is safe for constipation?

Answer 11

Basically everything

Fiber, 
decussate, 
Mg, 
lactulose, 
biscodyl

Question 12

Diarrhea meds?

Answer 12

Dietary changes (LOL)
Loperamide

Question 13

Is loperamide really pregnancy safe?

Answer 13

Human studies are inconclusive, however animal studies have shown teratogenic effects

Question 14

What is the preferred antipyretic?

Answer 14

Acetaminophen

Question 15

What are the preferred cough and cold meds for preggo’s?

Answer 15

Diphenhydramine and chlorphreniramine are preferred

Question 16

What about cough suppressants for pregnancy?

Answer 16

Opiates: neonatal withdrawl, abnormalities when used in 1st trimester

Guaifenisin: some risk of inguinal hernias

Benzonates: no data

Question 17

What is safe for rhinorrhea, sneezing and throat pain?

Answer 17

Saline spray

Cetylpryidinum (cepacol) is safe

Question 18

What should not be given for nose and throat stuff?

Answer 18

Decongestants: they reduce fetal blood flow and that is probably not the best thing for the new baby

Question 19

Beta-lactams in pregnancy?

Answer 19

Safe for All 3 trimesters

Question 20

Lincosalamides in pregnancy?

Answer 20

All 3 trimesters are good to go

Question 21

Nitrofurantoin?

Answer 21

Antibiotic for urinary tract infection

Safe for 2nd and 3rd trimester

Question 22

What abx should be avoided in pregnancy?

Answer 22

Sulfonamides: trimethoprim/sulfamethozazole (bactrum)

Fluoroquinolones: ciprofloxacin, levofolaxacin

Tetracyclines: tetracycline, doxycycline

Question 23

Nitromidazoles: Flagyl (metronidazole)?

Answer 23

ABX: Safe in 2nd and 3rd trimester

Question 24

What anti-fungals are pregnancy safe?

Answer 24

Fluconazole
Clotrimazole
Miconazole
Nystatin

Question 25

What anti-fungals are not safe for pregnancy?

Answer 25

Butoconazole Miconazole Ticonazole Never use these

Question 26

Can i give antivirals to pregnant women

Answer 26

Sure, the vir’s are good to go

Question 27

What about high potency steroids?

Answer 27

Sorry, you cannot have those

Question 28

Tretinoin (retin-A)?

Answer 28

No that will make a very unhealthy baby

Question 29

What is the primary and secondary drugs for chronic HTN in pregnancy (preeclampsia) Urgent/emergent (3 drugs)

Answer 29

Chronic: 1: Methyldopa 2: labetalol Urgent: 1. Hydralazine 2. Labetalol 3. Nifedipine

Question 30

What is the DOC for the treatment of eclampsia?

Answer 30

Magnesium sulfate IV

Question 31

Pregnancy and diuretics?

Answer 31

If a woman is on diuretics they are safe to continue however do not start them during gestation

Question 32

What about cardiac meds?

Answer 32

B-blockers : intrauterine fetal growth retardation ACEI and ARB’s: teratogenic

Question 33

How is gestational DM (GDM) treated?

Answer 33

Insulin is the preferred medication Glyburide and metformin are category B however they lack long term safety data

Question 34

What should every woman of reproductive age take?

Answer 34

Folic acid

Question 35

What are the 3 types of anemia commonly seen in preggo’s?

Answer 35

Iron, folate and b12

Question 36

Iron recommendation in pregnancy?

Answer 36

27mg/day ought to do it

Question 37

When snoop dogg is 60 how old will he be in dog years?

Answer 37

420