Pregnancy and Lactation Flashcards
(43 cards)
Where does fertilization occur, when does the fertilized egg reach the uterus, when does implantation occur
Fallopian tubes, Day 3, Day 8-10
What is used to diagnose pregnancy, what produces it, what is used to test for active pregnancy
Human chorionic gonadotropin (hCG), placenta, Beta-subunit of hCG
T/F: Preganancy tests are usually 97% accurate and usually false negatives because patients are testing to early
True
When is the highest amount of drug exposure of the fetus
The first trimester
What is gravidity and Parity
Gravidity= total number of pregnancies, parity= deliveries
What are the types of delieveries
T: term (greater than 37 weeks), P: preterm (20-37 weeks), A: abortion/ectopic, L: living children
T/F: If a patient is currently pregnant the Gravidity is always higher than the Parity
True
Which CYP enzymes are increased during pregnancy
3A4 and 2D6
How does drug transfer occur in placenta
Simple diffusion
What is the most common reasons for congenital defects
Idiopathic (spontaneous), genetic
In the old FDA system what did the categoes A-X mean
A: well controlled, no risk
B: less controlled, no risk
C: unknown risk
D: known risk but benefit may be greater than risk
X: Known risk and risk is greater than the benefit
In the new FDA system what changed
There are categories for pregnancy (trimesters), lactation, and fertility
If a patient is pregnant what should be done if they are taking AEDs, such as cabamazepine
Give the lowest dose possible instead of switching to an alternative agent
What program is used to prevent isotrentinoin from causing harm to pregancy
REMS program
What blood thinner is known to cause teratogenic effects, what should it be switched to
Warfarin, LMWH
T/F: If a woman is pregnant than can drink alcohol as long as it is a tiny amount
False: Drinking while prenant increases the risk of defects regardless of the amount
What vitamins and nutrients should pregnant women be consuming
Iron 30 mg (2nd and 3rd trimester)
Folate 0.4mg/day, 4mg/day if history of tube defects or taking epilepsy meds
Calcium 1000-1200 mg per day
For acute pain what pharmacological agents should be used
Acetaminophen, Fioricet, Hydrocodone plus APAP (short term)
What drug used for pain should not be used in the 2nd or 3rd trimester of pregnancy
NSAIDs
What antimigraine drug has limited use
Triptans
T/F: If a patient is pregnant with pain non-pharmacological options are preferred first
True
How often does nausea/vomiting occur in pregnancies, when does it mostly occur
50-90% of pregnancies, 1st trimester peaking between weeks 8 and 12
What pharmacological drugs are used for nausea and vomiting if it is mild
Pyroxidine (B6), Doxylamine, Diclegis (doxylamine/pyridoxine)
What pharmacological drugs are used for moderate nausea and vomitting, tips
Metoclopramide (Do not use more than 12 weeks)
Promethazine (suppository if needed)
Prochlorperazine (suppository if needed)
