Flashcards in Pregnancy, Breastfeeding And Paediatrics Deck (17):
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
What drugs are teratogenic?
Third element (Lithium)
What drugs affect later pregnancy?
How can hyperemesis be managed non-pharmacologically?
Eat smaller meals more frequently
Avoid spicy foods
What are the treatment options for hyperemesis?
1st line - cyclizine, promethazine
2nd line - metoclopramide, ondansetron, prochlorperazine
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
What is the second-line treatment for acid reflux in pregnancy?
Omeprazole or ranitidine
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
Describe the stages of foetal development
- day 1-17 - fertilisation -> cell division -> embryonic stage
- day 18-56 - organogenesis
- day 56 to end - maturation, development, growth
What are the treatment options for gestational diabetes?
1st line - diet and lifestyle modifications, metformin
2nd line - insulin
What drugs are most likely to cross into breast milk?
Low plasma protein binding
What drugs are least likely to cross into breast milk?
High protein binding
What drugs should be avoided during breastfeeding?
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
How is drug metabolism affected in neonates?
Efficiency of mechanisms may be impaired
Immaturity of liver and kidneys slows elimination
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