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Pregnancy Drug Risks
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1
Question
What risk do NSAIDs like ibuprofen and aspirin pose in the first trimester of pregnancy?
Answer
Not a major risk
2
Question
What adverse effect can indomethacin cause in late pregnancy regarding the ductus arteriosus?
Answer
Constriction of ductus arteriosus
3
Question
How does indomethacin in late pregnancy affect amniotic fluid?
Answer
Decreases fetal urine production leading to decreased amniotic fluid
4
Question
What is the daily dose threshold for low-dose aspirin considered safe in pregnancy?
Answer
100mg or lower daily with no increased risk
5
Question
Why should high-dose aspirin be avoided in the third trimester?
Answer
Risk of adverse fetal effects
6
Question
What severe defects are associated with leflunomide exposure in pregnancy?
Answer
Hydrocephalus, eye anomalies, skeletal abnormalities, death
7
Question
Why are aminoglycosides like gentamicin associated with nephrotoxicity and ototoxicity in preterm infants?
Answer
Due to effects on immature kidneys and ears
8
Question
What is the risk of prenatal exposure to aminoglycosides like streptomycin?
Answer
No adverse effects
9
Question
What cardiac defect is nitrofurantoin in the first trimester linked to with 3x increased risk?
Answer
Hypoplastic left heart syndrome
10
Question
What increased risks are associated with nitrofurantoin exposure in the first trimester besides hypoplastic left heart?
Answer
2x risk for clefts and atrial septal defects
11
Question
When is nitrofurantoin only appropriate during pregnancy?
Answer
When no other alternatives are available
12
Question
What syndrome does chloramphenicol cause in preterm infants?
Answer
Gray baby syndrome
13
Question
Why can't preterm infants handle chloramphenicol leading to gray baby syndrome?
Answer
Cannot conjugate and excrete it properly
14
Question
What symptoms characterize gray baby syndrome from chloramphenicol?
Answer
Abdominal distension, respiratory abnormalities, ashen-gray color, vascular prolapse
15
Question
Why should chloramphenicol be avoided in late pregnancy?
Answer
Risk of gray baby syndrome in the fetus
16
Question
How do sulfonamides worsen hyperbilirubinemia in newborns?
Answer
Displace bilirubin from protein binding sites
17
Question
What is the primary use of sulfonamides mentioned in pregnancy context?
Answer
Treat infections like MRSA
18
Question
What effect does tetracycline after 25 weeks of gestation have on fetal teeth?
Answer
Yellowish-brown discoloration of deciduous teeth
19
Question
What is the mechanism of cyclophosphamide as an antineoplastic drug?
Answer
Alkylating agent inflicting chemical insult on developing fetal tissues
20
Question
How does cyclophosphamide lead to heritable changes in fetal cells?
Answer
Causes cell death and DNA alterations in surviving cells
21
Question
What pregnancy risks increase with environmental exposures like cyclophosphamide?
Answer
Spontaneous abortion, pregnancy loss, malformations
22
Question
What teratogenic skeletal and other effects does cyclophosphamide cause?
Answer
Skeletal abnormalities, limb defects, cleft palate, eye defects
23
Question
What long-term issues do surviving infants from cyclophosphamide exposure face?
Answer
Growth abnormalities and developmental delays
24
Question
What are the clinical uses of methotrexate?
Answer
Cancer chemotherapy, immunosuppression for autoimmune disease and psoriasis, abortifacient, ectopic pregnancy treatment
25
Question
What syndrome is caused by fetal exposure to methotrexate?
Answer
Fetal methotrexate-aminopterin syndrome
26
Question
What cranial defect is characteristic of fetal methotrexate-aminopterin syndrome?
Answer
Craniosynostosis with clover-leaf skull
27
Question
What facial and limb features are seen in fetal methotrexate-aminopterin syndrome?
Answer
Wide nasal bridge, low set ears, micrognathia, limb deformities
28
Question
What is the primary use of tamoxifen in relation to pregnancy risks?
Answer
Adjuvant treatment for breast cancer
29
Question
What symptoms similar to DES exposure are caused by tamoxifen?
Answer
Diethylstilbestrol-like symptoms
30
Question
What protein does trastuzumab target in breast cancer treatment?
Answer
HER2 protein