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IOS 9 Exam 1
Pregnancy & lactation
| Question | Answer |
|---|---|
| 13 Med's teratogenic during organogenesis | Methotrexate, cyclophosphamide, carbamazepine, phenobarbital, phenytoin, valprotic acid, lithium, warfarin, thalidomide,isotretinoin, diethylstibesterol, Ace inhibitors |
| Strategies for drug selection | Agents used for the longest periods, lowest dose, discourage self-medication and encourage seek advice |
| FDA pregnancy A | Safe in controlled studies |
| FDA category B | No studies, no evidence of risk |
| FDA category C | Risk vs benefit- risk not ruled out |
| FDA category D | Benefit vs risk: Positive evidence of risk |
| FDA category X | Contraindicated: Do not use |
| Limitations with FDA categories | Compared to other countries 62/2236, requires RCT to establish safety, difficult to change classification |
| Reprotox-drug database | Fast and helpful. PK, Brand & generic, lactation, references |
| Shepards Catalog | Not helpful, no summary information |
| Perinatology.com | List of FDA risk, summary statements, breastfeeling w/studies |
| Otis pregnancy | Patient information |
| Medical Hx on pregnant women | Last menstral period, Meds, dose & duration, previous pregnancy, medical Hx, Is med essential, FHx |
| Literature evaluation | Information on dose, dates of therapy, crose the placenta, What do Rerorisk say about references |
| Strategies to reduce drug transfer | Meds with short T1/2, Higher bound cross placenta less, if QD give at bedtime, if multiple give immediately after breast feeding |
Created by:
liza001
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