Pregnancy
__ is the first line antibiotic treatment for a GBS positive laboring mother?
Pen G
Why does every newborn receive erythromycin eye ointment after birth?
Let's take it back to journal club! Why is tranexamic acid administered slowly through IV?
To avoid hypotensive side effects
Several factors should be considered when determining if a drug is compatible with breastfeeding. When looking at protein binding, would you generally want a high PB drug or a low PB drug?
High protein bound drugs decrease the infant's exposure to the medication and therefore, PB greater than 90% is generally considered compatible.
In preeclampsia, what drug is used to help prevent seizures?
Magnesium Sulfate
The __ trimester is when the embryo is most susceptible to birth defects caused by teratogens
First trimester (14 weeks)
Which anticoagulant is teratogenic in pregnancy?
Warfarin
In general, a relative infant dose (RID) of __ is considered safe for breastfeeding.
A. Less than 10%
B. Less than 30%
C. Less than 15%
10%
For a mother who is HBsAg-positive, what do guidelines state as the appropriate time window for neonatal HBIG administration?
HBIG should be given within 12 hours of birth.
In pregnancy, does Scr generally increase or decrease?
Decrease. Generally creatinine clearance increases by 50%.
Which TWO toxicities are associated with gentamicin?
Ototoxicity and Nephrotoxicity
Rule of thumb: after approximately how many half-lives do we consider complete elimination of a drug?
5
In the presence of preeclampsia, which lab would be most important to monitor?
a. Electrolytes
b. Hematocrit
c. Protein creatinine ratio
1. Protein creatinine ratio (would be elevated)
Other relevant labs:
BP (high)
Platelets (would be 100,000/micro/L or less)
creatinine (would be elevated)
What is the benefit of a single course of corticosteroids for pregnant women between 24.0 and 33.6 weeks of gestation at risk for preterm labor within 7 days?
To help with overall fetal maturation by decreasing:
1. Death
2. Respiratory distress
3. Intracranial hemorrhage
4. Necrotizing enterocolitis
What is the indication for tocolytic drugs in pregnancy?
These medications help to stop or suppress premature labor
Drugs of which molecular weight are more likely to cross into the breast milk?
A. 400 Da
B. 800 Da
400 Da. Generally, drug that exceed 800 Da do not pass easily into the milk compartment.
LC is a 25 y.o female who is 20 weeks gestation with a history of Factor V Leiden and a significant history of DVT during 1st pregnancy. Which anticoagulant is most appropriate?
A. Heparin 5,000 units BID
B. Lovenox 40mg SQ once daily
C. Warfarin goal INR 2-3
B. Lovenox 40mg SQ once daily
Preterm labor is very common on the LD floor. __ can help to stop or slow down preterm labor.
A. Beta-blockers
B. Calcium Channel Blockers
C. Diuretics
CCB
__ hours after vaginal birth do guidelines recommend it's safe to initiate an anticoagulant?
6 hours
Would drugs of a higher Vd or a lower Vd be more compatiable with breastfeeding?
Drugs enter the breast milk through blood supply. Drugs with high Vd can enter different compartments of the body resulting in lower concentrations within the blood. The preferable range is 1-20 L/kg.