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General Principles when prescribing drugs to pregnant patients
- Is the drug teratogenic
- Can the drug affect the near term fetus negatively
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Pregnancy Category A
- Adequate studies have failed to demonstrate risks to the fetus; no evidence of the risk in later trimesters
- Folic Acid
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Pregnancy Category B
- Animal Studies have failed to demonstrate a risk to the fetus or no adequate studies in humans; bad effects in animals but none in humans
- Acetaminophen, penicilins
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Pregnancy Category C
- Animal studies have shown an adverse effect on the fetus and there are no adequate studies in humans; or no studies are available in either animal or women. Potential benefit may warrant use
- Epi and Aspirin
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Pregnancy Category D
- Positive evidence of human fetal risk based on adverse reaction data, but potential benefits in serious situations may warrant its use
- Warfarin, Tetracycline
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Pregnancy Category X
- Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk, never administer
- Triazolam
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Pregnancy and Drugs
- Local anesthetics have been reported to produce fetal bradycardia and neonatal depression in large doses near term
- Lido and Prilocaine are category B
- Bupivicaine (teratogenic in rats) Class C
- Afternoon appt
- Recumbent position (Not Trendelenburg)
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