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Questions and Answers
Which antidiabetic drug is considered the drug of choice during pregnancy?
Which antidiabetic drug is considered the drug of choice during pregnancy?
What is the recommended analgesic for use during pregnancy?
What is the recommended analgesic for use during pregnancy?
Which of the following medications should be avoided during pregnancy due to the risk of neonatal hypoglycemia?
Which of the following medications should be avoided during pregnancy due to the risk of neonatal hypoglycemia?
Which vitamin should be avoided in excessive amounts during pregnancy due to its teratogenic effects?
Which vitamin should be avoided in excessive amounts during pregnancy due to its teratogenic effects?
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What is a safer choice of anti-infective agent during pregnancy?
What is a safer choice of anti-infective agent during pregnancy?
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Which vitamin has increased requirements during lactation?
Which vitamin has increased requirements during lactation?
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What dietary component is important for improving iron absorption in pregnant women?
What dietary component is important for improving iron absorption in pregnant women?
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Which of the following immunizing agents is recommended for women planning a pregnancy?
Which of the following immunizing agents is recommended for women planning a pregnancy?
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Which type of laxative is recommended as a first-line treatment for constipation during pregnancy?
Which type of laxative is recommended as a first-line treatment for constipation during pregnancy?
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What is the recommended management for nausea and vomiting in early pregnancy?
What is the recommended management for nausea and vomiting in early pregnancy?
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Which medication is considered the analgesic of choice for headache and back pain in pregnancy?
Which medication is considered the analgesic of choice for headache and back pain in pregnancy?
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Which of the following is NOT recommended during pregnancy for managing common cold symptoms?
Which of the following is NOT recommended during pregnancy for managing common cold symptoms?
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What is an important precaution for mothers on antiepileptic therapy during pregnancy?
What is an important precaution for mothers on antiepileptic therapy during pregnancy?
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Why is folic acid supplementation important during pregnancy?
Why is folic acid supplementation important during pregnancy?
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Which of the following laxatives may be considered if a stimulant effect is necessary during pregnancy?
Which of the following laxatives may be considered if a stimulant effect is necessary during pregnancy?
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What should be avoided to reduce the risk of worsening hemorrhoids during pregnancy?
What should be avoided to reduce the risk of worsening hemorrhoids during pregnancy?
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What is the concentration of caffeine in breast milk compared to the total dose taken by the mother?
What is the concentration of caffeine in breast milk compared to the total dose taken by the mother?
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What potential risk is associated with the use of chloramphenicol while breast-feeding?
What potential risk is associated with the use of chloramphenicol while breast-feeding?
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Which medication should be avoided in pregnant women receiving magnesium sulfate therapy?
Which medication should be avoided in pregnant women receiving magnesium sulfate therapy?
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Which substance is likely to cause sedation in breast-fed infants?
Which substance is likely to cause sedation in breast-fed infants?
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Which substance is known to suppress thyroid function in infants when taken by a nursing mother?
Which substance is known to suppress thyroid function in infants when taken by a nursing mother?
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What is a significant risk associated with the use of angiotensin converting enzyme inhibitors during pregnancy?
What is a significant risk associated with the use of angiotensin converting enzyme inhibitors during pregnancy?
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Which drug is known to cause fetal bradycardia and slow development when used during pregnancy?
Which drug is known to cause fetal bradycardia and slow development when used during pregnancy?
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What effect do high doses of oral contraceptives have during breast-feeding?
What effect do high doses of oral contraceptives have during breast-feeding?
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What are the potential effects of chronic use of barbiturates during pregnancy?
What are the potential effects of chronic use of barbiturates during pregnancy?
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What is the status of iodine (radioactive) in relation to breast milk?
What is the status of iodine (radioactive) in relation to breast milk?
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What impact did thalidomide have on infants born between 1959 and 1962?
What impact did thalidomide have on infants born between 1959 and 1962?
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Which of the following drugs has been indicated to cause congenital goiter?
Which of the following drugs has been indicated to cause congenital goiter?
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Which of the following is contraindicated during breast-feeding?
Which of the following is contraindicated during breast-feeding?
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Which drug is safe for breast-feeding in most cases?
Which drug is safe for breast-feeding in most cases?
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What is a known effect of smoking during pregnancy on fetal development?
What is a known effect of smoking during pregnancy on fetal development?
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What is a known effect of smoking during pregnancy on the infant?
What is a known effect of smoking during pregnancy on the infant?
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Which of the following is a common drug that may cause significant effects in breastfed infants?
Which of the following is a common drug that may cause significant effects in breastfed infants?
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At what point in gestation does the risk of yellow-brown discoloration of teeth due to tetracycline use become apparent?
At what point in gestation does the risk of yellow-brown discoloration of teeth due to tetracycline use become apparent?
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What potential health issue can be caused by the use of tetracycline during pregnancy?
What potential health issue can be caused by the use of tetracycline during pregnancy?
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Which medication is recommended as a first-line treatment for high blood pressure during pregnancy?
Which medication is recommended as a first-line treatment for high blood pressure during pregnancy?
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What long-term effect can smoking have on children exposed during pregnancy?
What long-term effect can smoking have on children exposed during pregnancy?
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What is a characteristic of Labetalol as a medication?
What is a characteristic of Labetalol as a medication?
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Which effect is associated with nicotine exposure to fetuses during pregnancy?
Which effect is associated with nicotine exposure to fetuses during pregnancy?
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Which type of medications are generally safe for controlling high blood pressure in pregnant women?
Which type of medications are generally safe for controlling high blood pressure in pregnant women?
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What does teratogenicity refer to?
What does teratogenicity refer to?
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What category of drugs has been shown to be safe for use during pregnancy in the first trimester?
What category of drugs has been shown to be safe for use during pregnancy in the first trimester?
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Which category of drugs shows positive evidence of human fetal risk?
Which category of drugs shows positive evidence of human fetal risk?
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Which drug is classified as Category X due to its teratogenic risk?
Which drug is classified as Category X due to its teratogenic risk?
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What is the main concern regarding drugs in Category C?
What is the main concern regarding drugs in Category C?
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What was the primary reason for thalidomide's controversial use during pregnancy?
What was the primary reason for thalidomide's controversial use during pregnancy?
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What distinguishes mutagenicity from teratogenicity?
What distinguishes mutagenicity from teratogenicity?
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Which statement is true regarding Category B drugs?
Which statement is true regarding Category B drugs?
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Study Notes
Drugs Used in Pregnancy and Lactation
- Drugs are categorized based on potential side effects on the fetus
- Different categories (A, B, C, D, X) exist
Gastroesophageal Reflux
- Antacids with low sodium and no aluminum may be recommended
- Omeprazole (take once daily), use with caution
Constipation
- Increase fiber intake, stay hydrated, and exercise
- Bulk-forming laxatives (e.g., ispaghula) are first-line treatment
- Osmotic laxatives (e.g., lactulose, sorbitol) may be considered
- Stimulant laxatives (e.g., magnesium salts) if needed
Nausea and Vomiting
- Usually begins before 9 weeks of pregnancy
- Often resolves by the second trimester (14 weeks)
- Vitamin B6 is recommended as first-line treatment
- Adding doxylamine (first-generation antihistamine) with B6 may reduce symptoms by 70%
Hemorrhoids
- May worsen during pregnancy
- Avoid straining at stool
- Use topical anesthetics and corticosteroids cautiously
- Astringents are preferred
Common Cold
- Avoid use of drugs, generally not curative
- Prefer topical decongestants (phenylephrine, oxymetazoline, or tramazoline)
- Systemic administration is less preferred in pregnancy and breastfeeding
- Use saline drops
Headache and Back Pain
- Common complaints during pregnancy
- Paracetamol is the analgesic of choice
Epilepsy in Pregnancy
- Anti-epileptics may increase risk of congenital malformations (neural tube defects)
- Dose adjustments are needed throughout pregnancy
- Single anti-epileptic drug is preferred over multiple
- Folic acid supplementation is recommended during planning and throughout the pregnancy
- Neonatal hemorrhage is a risk after birth, counteracted by vitamin K injection
- Mother compliance is crucial
Folic Acid
- 400 micrograms (mcg) of folic acid (vitamin B9) before and during pregnancy can reduce birth defects
- Lamotrigine and levetiracetam are relatively safer choices for women with epilepsy
Diabetes
- Blood glucose control is crucial during pregnancy
- Insulin is the preferred drug during pregnancy
- Sulfonylureas are relatively contraindicated due to neonatal hypoglycemia risk
- Metformin poses low risk of birth defects; safe for both before and during pregnancy, and while breastfeeding
Anti-Infective Agents
- Avoid co-trimoxazole, tetracyclines, griseofulvin, and ketoconazole
- Amoxicillin and erythromycin are recommended
Analgesics
- NSAIDs may delay labor onset and increase duration if taken in the third trimester, topical formulations preferred
- Paracetamol favored
Vitamins
- Increased vitamin and mineral requirements (folate, B2, B6, B12, C) during lactation
- Avoid megadose regimens
Immunization and Pregnancy
- Limit immunizing agents during pregnancy
- Consider tetanus toxoids (for accidents) and influenza vaccines based on case
- Rubella vaccination of women planning pregnancy should be promoted
Diet and Pregnancy
- Pregnant women need a healthy, balanced diet with increased calorie intake
- Include foods high in calcium, vitamin D, iron, and folate
- Avoid excessive vitamin A intake
- Iron rich foods, vitamin C supplementation (citrus fruit) for better absorption
Mutagenesis vs. Teratogenicity
- Mutagenesis is the ability of chemicals to alter the genetic material of egg or sperm by changing the nucleus
- Teratogenicity is the ability of chemicals to cause birth defects in the fetus after zygote formation
Drug Categorization
- Based on potential side effects on the fetus
- Category A: considered safe (e.g., some thyroid hormones)
- Category B: animal studies don't show harm; controlled studies in pregnant women lacking or inadequate
- Category C.: Animal studies showing potential teratogenic effects or human studies lacking
- Category D: Positive evidence of human fetal risk, but may be acceptable in life-threatening situations or severe diseases
- Category X: Studies show definite human fetal teratogenic risk; contraindicated for pregnant women
Thalidomide
- Famous example of teratogenic effects in humans: birth defects related to the administration of thalidomide to pregnant women
- Considered safe in testing, used to treat nausea, tension, and sleep issues
- German pediatrician (W. Lenz) and Australian physician identified thalidomide's teratogenic effects
- Approximately 8000 infants affected between 1959 and 1962
Smoking During Pregnancy
- Children whose mothers smoked exhibited developmental delays and lower birth weights
- Smoking impacts the fetus due to fetal hypoxia, intrauterine growth retardation, decreased fetal heart rate, and increased blood viscosity
Long-Term Effects of Smoking in Children
- Nicotine and cocaine are addictive, impacting developing fetuses
- Constriction of blood vessels and reduced oxygen delivery affecting the fetus, increasing the risk of pneumonia and bronchitis
Tetracyclines
- May cause yellow-brown discoloration of teeth if used in late pregnancy, when deciduous teeth are calcifying
- Oxytetracycline and doxycycline have a lower incidence of tooth staining
Medications for High Blood Pressure During Pregnancy
- Methyldopa: a first-line oral medication for hypertension; can be given intravenously in sever cases
- Labetalol: another first-line oral medication that causes vasodilation; can also be administered intravenously
- Nifedipine: a calcium channel blocker, use with caution in relation to magnesium sulfate treatment
- Hydralazine: oral or intravenous use for controlling hypertension in pregnancy (may be injected in severe cases)
Antihypertensives to Avoid During Pregnancy
- ACE inhibitors: associated with birth defects (fetal hypocephalic head, renal defects, anuria)
- Diuretics (furosemide, hydrochlorothiazide): should be avoided during pregnancy
- Propranolol: associated with birth defects like fetal bradycardia, slowed development, and neonatal hypoglycemia.
Drugs with Adverse Effects on the Fetus
- Specific drugs and their impact on fetus during pregnancy trimester
Common Drugs Excreted in Breast Milk
- Effects and comments on some common drugs impacting infant through breast milk intake
Drugs Contraindicated During Breastfeeding
- List of drugs to avoid during breastfeeding; drugs that may suppress lactation
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Description
This quiz covers essential information about medications and treatments for various conditions during pregnancy and lactation. It includes drug classifications, effective treatments for nausea, constipation, and more, while emphasizing safety for both mother and baby. Test your knowledge on managing common pregnancy-related health issues.
