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What supplements are needed for prenatal care?
- Iron: ↑ maternal blood volume expansion for cord needs and loss at birth
- Folate: ↓ neural tube defects
- Calcium: mineralization of fetal skeleton and teeth
- Omega-3 FA: supports brain and eye development
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What are the non-pharmacological tx for morning sickness?
- Eat small, dry meals that are high in carbs and low in fat
- Avoid precipitating factors (smells, sights, etc.)
- Shorter workdays and more naps
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What drugs are used for morning sickness?
- Metoclopromide
- Meclizine
- 1st gen antihistamines
- Ondansetron
- Promethazine (c)
- Prochlorperazine (c)
- Vitamin B6, B12
- Ginger root
- PremesisRx
- Accupuncture
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What SE does Metoclopromide now have a black box warning for?
tardive dyskinesia
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What is the DOC for morning sickness in many countries?
Metoclopromide
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What is the tx for Hyperemesis gravidarium?
- IV fluids
- Sedatives
- Antiemetics
- Enteral or Parenteral nutrition may be needed
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What is the non-pharmacological tx for constipation in pregnancy?
- Increase activity
- Increase fluids
- Increase fruits, vegetables, and whole grains
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What is the tx for constipation in pregnancy?
- Metamucil
- Citrucel
- Bisacodyl
- Senna (c)
- Docusate (c)
- PEG (c) (use for chronic constipation in Pg)
- MOM (low doses and occasional use only)
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What is the non-pharmacological tx for GERD in pregnancy?
- Eat small, frequent meals
- Avoid meals close to bedtime
- Avoid caffeine, alcohol, nicotine, salicylates
- Elevate the head of the bed
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What is the tx for GERD in pregnancy?
- Antacids (DOC) (avoid Mg in later Pg - may slow or stop labor or cause convulsions)
- Sucralfate
- H2RA and PPI are last line (esp. Nizatidine and Omeprazole)
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What is the tx for HTN in pregnancy?
- Methyldopa (DOC)
- Labetalol (3rd trimester data)
- Nifedipine (1st or 2nd line)
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What is the prophylaxis for pre-eclampsia in pregnant women at risk?
- ASA 81mg/d
- Calcium 1g/d (if low dietary Ca)
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What is the tx for pre-eclampsia?
Mg sulfate
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What is the tx for eclampsia?
Mg sulfate to all pre-eclamptic women during labor and 12-24 hrs post-partum
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What is the tx for VTE in pregnancy?
- LMWH (DOC)
- Unfractionated heparin (c)
- DO NOT use Warfarin
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What is the tx for antenatal depression?
- SSRI (except paroxetine)
- TCA
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What is the best resource for drug use in pregnancy?
Drug in Pregnancy and Lactation
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