Pregnancy, Breastfeeding And Paediatrics Flashcards Preview

Stage 3 Block 2 > Pregnancy, Breastfeeding And Paediatrics > Flashcards

Flashcards in Pregnancy, Breastfeeding And Paediatrics Deck (17):
1

What physiological changes occur during pregnancy?

Vascular resistance changes - increased HR and stroke volume
Plasma volume increases - decreased blood viscosity
Coagulation - increased clotting factors and decreased fibrinolysis
Increased renal blood flow
Reduced serum albumin
Increased progesterone - relaxes smooth muscle
Reduced GI motility

2

What drugs are teratogenic?

Thalidomide
Epilepsy drugs
Retinoids
ACEIs/ARBs
Third element (Lithium)
Oral contraceptives
Warfarin
Alcohol
Methotrexate
Danazol

3

What drugs affect later pregnancy?

ACEIs
Anti-thyroid drugs
Benzodiazepines
Beta-blockers
NSAIDs

4

How can hyperemesis be managed non-pharmacologically?

Eat smaller meals more frequently
Avoid spicy foods
Avoid caffeine

5

What are the treatment options for hyperemesis?

1st line - cyclizine, promethazine
2nd line - metoclopramide, ondansetron, prochlorperazine

6

What is the first line treatment for acid reflux in pregnancy?

Avoid trigger factors, tight clothing, big meals, smoking
Antacid with or without an alginate

7

What is the second-line treatment for acid reflux in pregnancy?

Omeprazole or ranitidine

8

What general advice should be given preconception?

Avoid drugs where possible
Avoid alcohol, smoking and vitamin A products
Reduce caffeine intake
Consider taking folic acid 400mcg OD
Rubella immunisation

9

Describe the stages of foetal development

Pre-embryonic
- day 1-17 - fertilisation -> cell division -> embryonic stage
Embryonic
- day 18-56 - organogenesis
Foetal
- day 56 to end - maturation, development, growth

10

What are the treatment options for gestational diabetes?

1st line - diet and lifestyle modifications, metformin

2nd line - insulin

11

What drugs are most likely to cross into breast milk?

Basic
Low plasma protein binding
High lipophilicity

12

What drugs are least likely to cross into breast milk?

Acidic
High protein binding
Low lipophilicity

13

What drugs should be avoided during breastfeeding?

Amiodarone
Aspirin
Barbiturates
Benzodiazepines
Carbimazole
COCs
Cytotoxic
Ephedrine
Tetracyclines

14

How is drug distribution affected in neonates?

Distribution of hydrophilic drugs depends on amount of body water
Distribution of hydrophobic drugs depends on amount of body fat
GFR increases with age

15

How is drug metabolism affected in neonates?

Efficiency of mechanisms may be impaired
Immaturity of liver and kidneys slows elimination

16

How is drug distribution affected in paediatrics?

Gastric emptying becomes equivalent to that of an adult over first 6 months of life
Stomach acid develops over 1-2years

17

How is drug metabolism in paediatrics affected?

Reduced capacity
Enhanced between 1-9years