Pharmacology Flashcards
<p>What antibiotics can you not give in pregnancy?</p>
<p>Trimethoprim and nitrofurantoin - teratogenic
Tetracyclines (e.g. doxycycline - affects baby's teeth)
Consider treating abx with cefalexin or amoxcillin</p>
<p>What antibiotics should be prescribed for PPROM?</p>
<p>Erythromycin 250mg QDS - prophylaxis to prevent chorioamnionitis
Suspect infection if high WCC, high CRP, maternal temperatures, fatal tachycardia</p>
<p>What antibiotics are given in caesarean sections?</p>
<p>1st gen cephalosporin (cefalexin) / penicillin </p>
<p>What steroids are given for fetal lung maturation and how?</p>
<p>Dexamethasone - 4X 6mg doses given as IM injections 12h apart
Beclametasone - 2X 12mg doses given 24h apart</p>
<p>What should you consider for the treatment of hypertension in pregnancy?</p>
<p>Labetalol 200mg TDS PO
Or Nifedipine 10mg OD-BD
Methyldopa 250mg BD or TDS PO (alpha 2 adrenergic receptor agonist)
IF SEVERE labetalol can be given IV or hydralazine or MgSO4</p>
<p>What can be given to help prevent pre-eclampsia?</p>
<p>Low dose aspirin (75mg)</p>
<p>What else is MgSO4 useful for?</p>
<p>NEUROPROTECTION - should be given to all women in pre-term labour BEFORE 30 weeks</p>
<p>What anti-emetics should be considered in hyperemesis?</p>
<p>Cyclizine 50mg TDS PO
Prochlorperazine 10mg TDS
Promethiazine 25mg TDS
Chlorpromazine 10-25mg
THEN
Metaclopramide (5-10mg) or ondansetron
THEN
Corticosteroids e.g. hydrocortisone (consultant decision)</p>
<p>What 2 laxatives should be considered in constipation in pregnancy?</p>
<p>BULK-FORMING (e.g. methycellulose)
| OSMOTIC eg. lactulose</p>
<p>What pharmacological treatment could you consider for obstetric cholestasis?</p>
<p>Ursodeoxycholic acid - reduces cholesterol absorption for the intestines helping with the dissolving of cholesterol
8-12mg OD before bed</p>
<p>What pharmacological treatments can be considered for PPH?</p>
<p>SYNTOMETRINE - (syntocinon + ergometrine = contraction of uterus)
CARBOPROST (PG analogue) - helps to contract down uterus 250mcg doses no less than 15mins apart no more than 2mg max
MISOPROSTOL 1000mcg rectal
TRANEXAMIC ACID
If these things fail consider surgical management - Intra-Uterine balloon tamponade, B-lynch sutures, uterine or iliac artery ligation, hysterectomy</p>
<p>When can a termination of pregnancy be managed MEDICALLY?</p>
<p>< 9 weeks</p>
<p>What is the first stage of treatment for a medical TOP?</p>
<p>Mifepristone 200mg - competitive progesterone receptor antagonist
- terminates pregnancy but need help to get it out hence next stage</p>
<p>What is the second stage of management for a TOP?</p>
<p>Misoprostol 800mcg - prostaglandin analogue, stimulates uterine contractions</p>
<p>When can a medical management of an ectopic pregnancy can be considered?</p>
<p>1) <35mm
2) Unruptured
3) No pain
4) BHCG levels are <1500
5) No FHR
6) If intra-uterine pregnancy has been effectively ruled out
**if a woman does not fulfil these criteria should consider surgical management of the ectopic either with salpingectomy or salpingostomy</p>