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Disorders during Pregenancy Flashcards

(64 cards)

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1
Q

What physiological changes begin during the first trimester of pregnancy?

A

Increased plasma volume, cardiac output, GFR, hepatic perfusion, and fat volume of distribution

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2
Q

How does pregnancy affect drug elimination?

A

GFR increases by 30-50%, leading to increased drug elimination

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3
Q

What is the effect of hepatic enzyme induction during pregnancy?

A

Increased metabolism of drugs primarily by estrogen and progesterone

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4
Q

What happens to the volume of distribution of fat-soluble drugs during pregnancy?

A

It increases due to increased fat volume

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5
Q

Fill in the blank: Acidic drugs are better absorbed in ______ environments.

A

Acidic

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6
Q

What is a common non-pharmacological treatment for constipation during pregnancy?

A

Moderate physical exercise and increased fluid and dietary fiber intake

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7
Q

What is the first choice pharmacological treatment for constipation during pregnancy?

A

Bulk forming agents (e.g., Psyllium, Methylcellulose)

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8
Q

Which type of laxatives should be avoided in pregnant women?

A

Stimulant laxatives like Senna and Bisacodyl

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9
Q

What lifestyle modifications can help manage GERD during pregnancy?

A

Small frequent meals, avoiding spicy/fatty foods, and head elevation at bed

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10
Q

What is the first line pharmacological treatment for GERD in pregnancy?

A

Antacids (Aluminum, Calcium, Magnesium) and Sucralfate

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11
Q

True or False: PPIs are a safe choice for treating GERD in pregnancy.

A

False

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12
Q

What is hyperemesis gravidarum?

A

Severe vomiting causing weight loss, dehydration, electrolyte imbalance, and ketonuria

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13
Q

What dietary modification is recommended for managing nausea and vomiting in pregnancy?

A

Eating frequent small soft meals and avoiding fatty and spicy meals

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14
Q

What is the first-line drug for nausea and vomiting during pregnancy?

A

PYRIDOXINE (Vit B6) and DOXYLAMINE

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15
Q

What is the prevalence of GDM during pregnancy?

A

3-5%

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16
Q

What is the first line treatment for GDM?

A

Nutritional education, diet modification, mild exercise, and blood glucose monitoring

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17
Q

What are the complications associated with hypertension during pregnancy?

A

Macrosomia, congenital malformations, fetal loss

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18
Q

What is the first choice pharmacological treatment for hypertension in pregnancy?

A

Methyldopa

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19
Q

What is the recommended treatment for eclampsia?

A

Magnesium sulfate (IV) infusion

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20
Q

What is the risk factor for venous thromboembolism (VTE) during pregnancy?

A

5-10 folds higher risk

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21
Q

What is the first choice treatment for VTE in pregnant women?

A

Low Molecular Weight Heparin (LMWH)

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22
Q

What is the primary cause of UTIs during pregnancy?

A

E-coli (75-90%)

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23
Q

What is the recommended treatment for asymptomatic bacteriuria during pregnancy?

A

B-lactam antibiotics (Amoxicillin, 2nd/3rd Cephalosporins) and Nitrofurantoin for 7-14 days

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24
Q

What is the treatment for Group B Streptococcus during pregnancy?

A

PENICILLIN-G IV (Ampicillin alternate)

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25
What non-pharmacological treatment can be used for allergic rhinitis during pregnancy?
Avoiding allergens and using immunotherapy
26
What is the recommended acute treatment for bronchial asthma during pregnancy?
SABA (Albuterol) and inhalational corticosteroid (Budesonide)
27
What is the recommendation for women on anti-seizure drugs during pregnancy?
Take folic acid (4-5 mg/day) starting before and throughout pregnancy
28
What is a significant risk associated with valproic acid during pregnancy?
Neural tube defects (spina bifida) and cognitive teratogenicity
29
What is the treatment for untreated hypothyroidism during pregnancy?
Levothyroxine 0.1 mg/day
30
What is the purpose of tocolytic therapy during preterm labor?
To delay labor for antenatal corticosteroid therapy and transportation
31
Fill in the blank: The only tocolytic that reduces neonatal morbidity is _______.
SLOW RELEASE Nifedipine
32
What is the problem associated with ineffective labor or hyperstimulation?
It is referred to as 'متوسط خليك' ## Footnote This term indicates an issue with labor progression.
33
What is the name of the PGE2 analog used in labor induction?
Dinoprostone
34
What is the recommended position for a patient after an intracervical insertion of Dinoprostone?
Remain supine for 30 min
35
When should the Dinoprostone insert be removed?
When labor begins or after 12 hours
36
What should be monitored during the insertion of Dinoprostone?
Fetal heart during the entire period of insertion and 15 min after its removal
37
What is the name of the PGE1 analog used for labor induction?
Misoprostol
38
How is Misoprostol administered?
Intravaginally
39
What are the adverse effects of Misoprostol?
* Hyperstimulation * Meconium stained amniotic fluid
40
In which patients is Misoprostol contraindicated?
Women with previous uterine scar due to risk of uterine rupture
41
What is the primary use of Oxytocin?
Labor induction after cervical ripening
42
When should antenatal corticosteroids be administered to a mother?
Between 24-34 weeks for 2 days
43
What is the purpose of antenatal corticosteroids?
To promote lung maturity and prevent RDS, intraventricular hemorrhage, and infant death in premature delivery
44
What are the two corticosteroids mentioned for antenatal use?
* Betamethasone 12 mg/day for 2 doses * Dexamethasone 6 mg/12 hours for 4 doses
45
What type of pain is experienced during the 1st phase of labor?
Visceral pain due to uterine contractions
46
What type of pain is experienced during the 2nd phase of labor?
Visceral pain due to perineal stretching
47
What are the adverse effects of parenteral opioids during labor?
* Maternal drowsiness * Nausea * Vomiting * Infant withdrawal
48
What is considered the best pain relief method during labor?
Epidural analgesia
49
What two types of medications are used in epidural analgesia?
* Opioid (Fentanyl) * Local anesthetic (Bupivacaine)
50
What are the adverse effects of epidural analgesia?
* Hypotension * Prolongation of 1st + 2nd labor stages * Nausea * Vomiting * Maternal fever * Pruritus * Inability to void * Rarely severe headache
51
What is the effect of nitrous oxide during labor?
Reduces anxiety and lessens pain perception but does not eliminate pain
52
What class of medications is recommended for constipation?
* Bulk forming agents (Psyllium, Methylcellulose, Polycarbophil) * Osmotic laxatives (Polyethylene glycol, Lactulose, Sorbitol) * Stimulant laxatives (Senna, Bisacodyl)
53
What is the first-line treatment for nausea and vomiting in pregnancy?
Pyridoxine (Vitamin B6) and Doxylamine
54
What is the drug of choice for gestational diabetes?
Insulin
55
What are the first-line medications for hypertension in pregnancy?
Labetalol
56
What is the recommended daily calcium supplement for patients with low calcium intake?
1-2 g daily
57
What is the minimum duration for low molecular weight heparin (LWMH) during pregnancy?
>3 months
58
What is the preferred antibiotic for Group B Streptococcus (GBS) prophylaxis?
Penicillin-G IV
59
What is the treatment for asymptomatic bacteriuria during pregnancy?
B-lactam (Amoxicillin and Cephalosporins) + Nitrofurantoin for 7-14 days
60
What is the only tocolytic that reduces neonatal morbidity?
Slow release Nifedipine
61
Which medication is the worst for epilepsy during pregnancy?
Valproic acid (VPA)
62
What should women with hypothyroidism take during pregnancy?
Levothyroxine 0.1 mg/day and monitor TSH every 4-6 weeks
63
What is the first-line medication for hyperthyroidism in the first trimester?
Propylthiouracil (PTU)
64
What is the use of low dose aspirin in high-risk VTE patients?
75-100 mg/day for patients with prosthetic heart valve

Gyne (3 decks)

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