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Flashcards in Prescribing in Pregnancy Deck (39)
1

Which anti coagulant does not cross the placenta and is therefore considered safe in pregnancy

Unfractionated heparin (large molecular weight)

2

What are the four components of pharmacolkinetics

Absorption
Distribution
Metabolism
Elimination

3

How is absorption affected in pregnancy

Morning sickness

4

Distribution

More fat store
Increased plasma volume

Distriubution increases

5

Metabolism

Decreased protein binding results in increased free drug
Increased liver metabolism of some drugs (phenytoin)

6

Elimination

GFR increases so renally excreted drugs are eliminated quicker

7

Name drugs which have narrow therapeutic windows

Lithium
Digoxin

8

what drugs may pregnant women be more sensitive too

Antihypertensives- can cause hypotension in 2nd trimester

9

When should folic acid be taken

for three months prior to and up to first 12 weeks of pregnancy

10

When is the period of greatest tetatrogenic risk

4th-11th week

11

Name teratogenic drugs

ACE/ARBs
Androgens
Antiepilptics
Cytotoxics
Lithium
Methotrexate
Retinoids
Warfarin

12

ACE/ARBs

renal hypoplasia

13

androgens

virilisation of femal foetus

14

antiepileptics

cardiac, facial, limb, neural tube defects

15

cytotoxins

defects, abortion

16

lithium

CVS defects

17

methotrexate

skeletal defects

18

Retinoids

ear, CVS, skeletal defects

19

Warfarin

limb and facial defects

20

What was DES shown to cause

vaginal adenocarcinoma in the daughters of those exposed during pregnancy
Urological malignancy was also found in sons of those exposed

21

What are frequent sezures in pregnancy associated with

lower verbal IQ in child, hypoxia, bradycardia, antenatal death, maternal death

22

Which antiepileptics should be avoided in pregnancy

valproate
phenytoin

Monotherapy prefered

23

What additional precaution should be taken for women with epilepsy in pregnancy

5mg (higher dose) of folic acid

24

Is insulin safe in pregnancy

yes

25

Are sulphonylureas safe in pregnancy

no

26

what is the safes anto emetic

cyclizine

27

what antibiotic is the best to use in pregnancy for a UTI

amoxicillin
cefalexin

28

is paracetemol safe

yes

29

Are antacids safe

yes

30

what is the leading cause of maternal death in pregnancy

VTE - assess all women for their risk

31

How should those with a high risk of VTE be treated

LMWH at delivery and 7 days post partum

32

What are the risk factors for VTE in pregnancy

obesity
age more than 35
para more than 3
previous DVT
C section

treat if more than 2

33

Amioderone in breasfeeding

neonatal hypothyroidism

34

cytotoxics in breastfeeding

bone marrow suppression

35

Benzodiazepines

drowsiness

36

Bromocriptine

suppresses lactation

37

Which antibiotic given during pregnancy or early childhood can cause teeth staining

tetracyclines

38

which antiepileptic is particularly associated with cleft palate

phenytoin

39

which antiepileptic drug is particularly associated with anencephaly and spinabifida

valproate