S2E4: Pregnancy/lactation Flashcards Preview

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Flashcards in S2E4: Pregnancy/lactation Deck (26):
1

1 mo before conception

400-800 mcg folic acid

2

3-12 w after conception (whats happening?)

organogenesis

3

Category A

Human studies show no risk

4

Category B

Ok in animals, not studied in humans.

5

Category C

Animals show bad effects. Use if benefit > risk

6

Category D

Evidence of human risk. Could still use is benefit > risk

7

Category X

Animal or human studies show fetal risk > benefit

8

Peri-conception rx

folic acid 400 mcg
flu vaccine 2nd or 3rd trimester

9

Morning sickness tx

doxylamine, vit B6 (pyridoxine), meclizine, dimenhydrinate, diphenhydramine, ondasetron, metoclopramide, phenothiazines

10

Heart burn tx during pregnancy

1: antacids (mag, Al, Ca carbonate), sucralfate
2: H2 blocker, PPI

11

Constipation tx during pregnancy

1. metamucil, citrucel, surfactants
2. stimulants
*avoid mineral oil

12

HA tx during pregnancy

rest, ice, APAP
*avoid NSAIDs, migraine rx (triptans, ergotamine)

13

Coag d/o tx during pregnancy

heparin (unfrac or frac OK)
enoxaparin (LMWH)
*NO WARFARIN after 6 wk

14

GDM tx

1. insulin (NPH/intermediate + regular insulin)
2. metformin (glyburide)

15

HTN (pregnancy induced) tx

1. Methyldopa + Ca
2. Labetolol, nifedipine
*NO ACE-I or ARB

16

UTI tx during pregnancy

Ampicillin, cephalexin, nitrofurantoin
*No tetracyclines or FQL

17

Syphilis tx during pregnancy

PCN

18

Gonorrhea tx during pregnancy

ceftriaxone

19

Chlamydia tx during pregnancy

erythromycin

20

asthma tx during pregnancy

albuterol and inhaled corticosteroids (flovent)

21

Allergic rhinitis tx during pregnancy

inhaled corticosteroids and 1st gen antihistamines (diphenhydramine)
2nd gen antihystamine (Cetirazine (zyrtec) and Loratadine (claritin)) only if clearly needed.

22

Depression tx during pregnancy

1. SSRIs (fluoxetine, sertraline, citalopram) with TCAs (amitryptyline, nortriptyline)
2. buproprion
*No paroxetine (SSRI) during pregnancy, but preferred during lactation

23

Depression tx during lactation

1. sertraline, paroxetine, or TCAs
*avoid fluoxetine (transition to paroxetine or sertraline after delivery)

24

Allergic rhinitis tx during lactation

short term: antihistamines
long term: nasal steroid or cromlyn

25

asthma tx during lactation

inhaled steroids (flovent)

26

HTN tx during lactation

labetalol, atenolol, metoprolol, nifedipine, enalapril, captopril
*labetalol, nifedipine also ok in pregnancy
*enalapril, captopril only ACE-Is that are ok (but remember, not in pregnancy!!)
*no ARBs