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6 Cards in this Set
- Front
- Back
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Describe the categories of medicines in pregnancy
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A = a-ok, generally safe. Large no of women, no proven harm. Penicillin, paracetamol
C = careful, may cause harm. Known to cause/ may cause harm, but NOT MALFORMATIONS. May be REVERSIBLE. Opioids, BZD's, metoprolol, prochlorperazine, sulphonamides B = 'buggered if I know' e.g. Insufficient data B1 animal studies show no harm B2 insufficient animal studies, but no known harm. Ranitidine, fluclox B3 harm in animal studies D = danger, risk irreversible harm. Known, likely or suspected MALFORMATION or IRREVERSIBLE damage. Phenytoin, warfarin, ACE inhibitors, doxy, gent X = x-men, high risk teratogens. Methotrexate, chemo therapeutics, roaccutane |
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What is the most dangerous period? What percentage congenital malformations due to drugs?
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4-11/40 post LMP, embryonic period. Most likely time for structural birth defects.
2% |
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All of the following are not recommended in pregnancy (D OR X). Which are permitted in breast feeding?
Chemo therapeutic agents Warfarin Aminoglycosides Tetracyclines Phenytoin CBZ valproate Tetracyclines Aspirin Sulphonamides Lithium Methotrexate |
Warfarin
Aminoglycosides Phenytoin CBZ Valproate Aspirin (small doses) (e.g chemo therapeutics, chloramphenicol, lithium and sulphonamides, methotrexate - these five are NEVER SAFE drugs and are either category D or X AND not permitted in breast feeding) |
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Of the following category A or B drugs in pregnancy which are NOT permitted in breastfeeding?
Prednisolone Loratadine Chloramphenicol Isoniazid Digoxin Nitrofurantoin Ranitidine Penicillins Metronidazole Erythromycin Cephalosporins |
Chloramphenicol A
Isoniazid A Nitrofurantoin A Ranitidine B1 Metronidazole B2 Prednisolone, loratadine, Digoxin, penicillins, erythromycin, cephalosporins - all are category A or B AND permitted e.g always safe drugs. Other always safe drugs include paracetamol, |
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Most drugs are excreted to a minor extent in breastfeeding exposing infant to doses well under therapeutic level. T/f
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True. Drugs cross placenta more efficiently than enter breast milk
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Of the following lists of medications, choose which are 'safe' and 'unsafe' in pregnancy
Analgesia - opioids, salicylates Antiemetic - ondansetron, prochlorperazine CVS - adenosine, amiodarone, lignocaine, verapamil, metaraminol, digoxin, adrenaline What category is heparin? Gabapentin, topi rampage |
Opioid generally safe (c) reversible respiratory depression, salicylates UNSAFE stillbirth, bleeding complications
Ondansetron B1, prochlorperazine UNSAFE cat C - neuro disturbance if high doses late pregnancy Adenosine b2, lignocaine a, verapamil c (not sure why this is 'safe when cat c', but according to Dunn) digoxin a, adrenaline a - all safe Amiodarone c, metaraminol c, ace/ang2 d - considered unsafe Heparin and LMW - cat C Gabapentin, topiramate are cat B - most other antiepileptics are D |
