Medications and pregnancy Flashcards
(12 cards)
Why are NSAIDs avoided in pregnancy?
They block prostaglandins, which are important in maintaining the ductus arteriosus in the fetus, softening the cervix, and stimulating uterine contractions.
When are NSAIDs particularly avoided?
In the third trimester, as they can cause premature closure of ductus arteriosus and can delay labour.
Why can’t you use beta blockers in pregnancy?
They can cause fetal growth restriction, hypoglycaemia in the neonate, and bradycardia in the neonate.
Why can’t you use ACE or ARBs in pregnancy?
They can cross the placenta and enter the fetus, affecting kidneys and reducing urine production, leading to oligohydramnios. They can also cause hypocalvaria.
What can ACE and ARBs cause when used in pregnancy?
Oligohydramnios, miscarriage or fetal death, hypocalvaria, renal failure in the neonate, and hypotension in the neonate.
Why can’t you use opiates during pregnancy?
They can cause withdrawal symptoms in the neonate after birth, known as neonatal abstinence syndrome.
How does neonatal abstinence syndrome present?
Between 3-72 hours after birth with irritability, tachypnoea, high temperatures, and poor feeding.
Why is warfarin not used in pregnancy?
It is teratogenic, causing congenital malformations, fetal loss, and bleeding during pregnancy, postpartum haemorrhage, fetal haemorrhage, and intracranial bleeding.
When is lithium normally used?
As a mood stabilising medication for patients with bipolar disorder, mania, and recurrent depression, which is avoided in pregnant women unless other options have failed.
Why is lithium avoided in pregnancy?
It is associated with congenital cardiac abnormalities and Ebstein’s anomaly, where the tricuspid valve is lower on the right side of the heart, resulting in a bigger right atrium and smaller right ventricle.
What are the risks of SSRIs?
In the first trimester, they can cause congenital heart defects. In the third trimester, they can lead to persistent pulmonary hypertension in neonates. Neonates may also experience withdrawal symptoms.
Why is isotretinoin not used in pregnancy?
It is highly teratogenic, causing miscarriage and congenital defects.
