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18 Cards in this Set
- Front
- Back
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What is the X contra-indicated drug Fitzy wants you to memorize? why?
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Warfarin d/t thromboembolic events are the leading causes of pregnancy related mortality
- prevents protein transformation to functional protein |
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Which organ is the last to mature in the fetus?
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Lungs therefore watch out for RDS because surfactant has not matured
- this can be reduced by giving antenatal corticosteroids |
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Indications for antenatal corticosteroids?
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• Threatened pre-term labour
• Antepartum hemorrhage • Preterm rupture of membranes • Conditions requiring Caesarian delivery (pre-eclampsia, HELLP, etc.) |
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Antenatal corticosteroids used for fetal surfactant?
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Betamethasone- DOC- 2 doses 24hrs apart
Dexamethasone- 4 doses 12 hrs apart |
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Betamethason Times more potent than cortisol
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20x more potent than cortisol
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MOA for corticosteroids
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1. gcr binding
2. dissociation 3. dimerization 4. translocation 5. Transcription of of surfactant proteins which drive Alveolar type 2 pneumocytes |
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What is C/I to using steroid in pregnant mother
S/E? |
Mother w/infection or TB
S/E mutliple courses for 7 days rx side effects (growth retardation, sepsis, brain developmental delay, adrenal insufficiency, enterocolitis) |
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What are drug class that could delay delivery for 24-48 hrs
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tocolytic drugs
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What are the types of tocolytic drugs?
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B2 agonists- Terbutaline, Ritodrine
Nifedipine- Ca channel blocker Indomethacin- COX enzyme blocks uterine PGF2a formation MgSO4- Ca competitor |
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Which of the tocolytics can be used at all ages...
Which can not be used after 34 wks of fetus? |
Terbutaline, Ritodrine, Nifedipine
- Indomethacin- could cause premature closure of ductus |
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NSAID use in the 3rd trimester increases chance of?
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Prolongation of labor, postpartum hemorrhage, and gastric irritation
Fetal adverse effects range from oligohydramnios and intrauterine closure of the ductus arteriosus to persistent pulmonary hypertension and fetal death |
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What keeps the PDA open?
How do you close the PDA? |
prostaglandin E2 (PGE2)
- NSAID (indomethacin) but only good in pre-mature babies |
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What types of babies need PDA to be maintained... what do you give for that?
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give- PGE1- ("alprostadil") for certain heart conditions
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When does kidney develop to full potential?
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1-3 year
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Sulfonamides and children S/E?
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Sulfonamides - kernicterus
–Neonatal encephalopathy due to bilirubin displacement & poor bilirubin clearance |
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Chloramphenicol causes what in babies?
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Grey baby syndrome
- abdominal distension, diarrhea, vomiting, dusky gray color, circulatory collapse & death - drug concentration dependent – impaired glucuronidation in neonates – impaired renal clearance |
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Jaundice vs. Kernicterus?
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jaundice- excess bilirubin in blood
Kernicterus- excess bilirubin in brain |
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ABs and rx for prego rx?
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A
B- B lactams generally considered safe C- fluoroquinolones, trimethoprim (birth defect) D- tetracycline (fatt liver) X |
