Drug use in pregnancy

Question 1

pregnancy category A

Answer 1

controlled studies in animals and women show no risk in the 1st trimester to the fetus

Question 2

pregnancy category B

Answer 2

1. animal studies have show an adverse effect but not confirmed w/ studies done on women in the 1st trimster
2. OR animal studies have not shown an effect on risk but no controlled trial on wome

Question 3

pregnancy category C

Answer 3

1. human /animal studies not available

2. animal studies shown harm but no studies done on humans

Question 4

pregnacncy category D

Answer 4

positive evidene of fetal risk available. Benefits> risk if it is a life threatening disease

Question 5

pregnancy category X

Answer 5

fetal abnormalities in humans or animals. Use is contraindicated

Question 6

what does hCG + mean?

Answer 6

it means that the patient is pregnant

Question 7

five of the top known teratogens (not comprehensive list)

Answer 7

alcohol
ACE/ARBS 
NSAIDS
Warfarin
Statins
SWAN

Question 8

what vitamins should a women who might get pregnant be on?

Answer 8

folic acid 400-800mcg/day a
calcium 1000mg daily
and vitamine D 600IU diaily

Question 9

natural sources of folic acid

Answer 9

some fortifiied cereals
dried beans
leafy green vegetables
orange juice

Question 10

pregnancy and N ausea, Vomiting? TX non pharm

Answer 10

• smaller more requent meals
• avoid spicy or smelly foods
• reducing stress
• take more naps

Question 11

pregnancy and N ausea, Vomiting? TX pharm

Answer 11

pyridoxime +/- doxyalamine

Question 12

pregnancy and GERD/Heartburn/Gas pain? TX non pharm

Answer 12

• small more frequent meals
• avoid foods that make gerd arose
• if when sleeping, elevated head of bed
• do not eat > 3 ours before sleeping

Question 13

pregnancy and GERD/Heartburn/gas pain? TX pharm

Answer 13

first line antacids: calcium carbonate.
H2RAs : caegory B :pepcid, tagament axid, zantac,
PPIs: cagetory B / C

Question 14

pregnancy and gas? TX pharm

Answer 14

simethicone is safe

Question 15

pregnancy and constipation? TX non pharm

Answer 15

drink more fluid
indrease fiber
increase walking

Question 16

pregnancy and constipation ? TX pharm

Answer 16

fiber is firts line

Psyllium is category B

Question 17

pregnancy and cold flu allegies? TX pharm

Answer 17

• doxylamine first line
• diphenhydramine is cageogry B
• pseudoephdrine, phenyleprhine, oxymetazoline, dextromethorphan, guaifensie are category C

Question 18

pregnancy and Pain? TX pharm

Answer 18

APAP

Question 19

can pregant patients get vaccines?

Answer 19

yes, but as long as they are not live vaccines

Question 20

are antibiotics safe in pregnancy?

Answer 20

yes as long as thye are not fluoroquinolones aor tetracyclines , SMx/TMP avoid in third trimester

Question 21

UTI and pregnancy tx

Answer 21

beta lactams OK
NItrofurantoin 100mg po bid, except in last weeks of pregnancy
fosfomycin 3g x 1

Question 22

chlamydia and pregnancy

Answer 22

azithromycin 1g x 1

or amox 500mg po tid x 7 days

Question 23

gonorrhea and pregnancy

Answer 23

cephalosporin

or azithromycin 2g x 1

Question 24

pregnancy and bacterial vaginosis

Answer 24

300mg po bid x 7 days
metronidazole 500mg bid or 250mg tid x 7 days
NOT TOPICALS!

Question 25

vagina trichomoniaisis and pregnacy

Answer 25

2g mentronidazole x 1
250 tid x 7 days
500mg bid x 7 days

Question 26

asthma and pregnancy

Answer 26

inhaled coricosteroid long term (budesonide preferred)

-albuterol rescue therap