NGR 6172 Quiz 2 (Chapters 7, 8, 9, and 10) Questions With
Complete Solutions
What Rx are contraindicated during breastfeeding?
(other than controlled substances + Anticancer agents +
Immunosuppressants)
Atenolol + Bromocriptine
Ergotamine + Lithium
Nicotine + Radioactive agents
What analgesics are Rx of choice for breastfeeding pts?
Acetaminophen, Ibuprofen, Flurbiprofen, Ketorolac
Mefenamic acid, Sumatriptan, Morphine
What anticoagulants are Rx of choice for breastfeeding pts?
Warfarin, Acenocoumarol, Unfractionated Heparin
Large size of unfractionated heparin = ↓ amount excreted in
breast milk. Also, it's not bioavailable in GI tract.
What Antidepressants are Rx of choice for breastfeeding pts?
Which one should you use caution in giving?
Sertraline, Paroxetine, TCAs
Fluoxetine if other SSRIs ineffective; but caution bc levels are
higher in breast milk than other SSRIs
,Serene Parrots Try, but Flu floats higher
What antiepileptics are Rx of choice for breastfeeding pts?
Carbamazepine, Phenytoin, Valproic Acid
What Antihistamines are Rx of choice for breastfeeding pts?
Which ones should be avoided? Why?
Loratadine + Fexofenadine
1st gen antihistamines assoc. w/ irritability, or sedation + may ↓
milk supply
What Antimicrobials are Rx of choice for breastfeeding pts?
Which ones should be avoided?
Good = Cephalosporins, Aminoglycosides, Macrolides, PCN
Bad = Chloramphenicol + Tetracycline
What Beta-Blockers are Rx of choice for breastfeeding pts?
What other BP Rx are safe?
Labetolol, Metoprolol, Propanolol
*ACE-inhibitors + CCBs also safe*
What Endocrine Rx are okay for breastfeeding pts?
, Propylthiouracil (PTU)
Insulin
Levothyroxine
What Glucocorticoids are Rx of choice for breastfeeding pts?
Prednisone + Prednisolone
What can Retinoids (Isotretinoin, etretinate, large doses of Vit
A) cause during pregnancy?
CNS + Craniofacial + CV Defects
Thymus abnormalities
If a pregnant pt has been exposed to a known teratogen, but after
organogenesis (weeks 3-8), what should you do as a provider?
#1 = Determine timing
(if not taken during organogenesis weeks 3-8, reassure that risk
of malformation minimal)
If a pregnant pt has been exposed to a known teratogen during
organogenesis (weeks 3-8), what should you do as a provider?
#1 = Consult reference on to determine expected malformations
#2 = 2+ ultrasounds to determine extent
Mild anomalies: surgery possible (e.g., cleft palate)
Severe: Consider termination
What factors determine if an Rx enters into breast milk?
Same that determines passage across membrane
Complete Solutions
What Rx are contraindicated during breastfeeding?
(other than controlled substances + Anticancer agents +
Immunosuppressants)
Atenolol + Bromocriptine
Ergotamine + Lithium
Nicotine + Radioactive agents
What analgesics are Rx of choice for breastfeeding pts?
Acetaminophen, Ibuprofen, Flurbiprofen, Ketorolac
Mefenamic acid, Sumatriptan, Morphine
What anticoagulants are Rx of choice for breastfeeding pts?
Warfarin, Acenocoumarol, Unfractionated Heparin
Large size of unfractionated heparin = ↓ amount excreted in
breast milk. Also, it's not bioavailable in GI tract.
What Antidepressants are Rx of choice for breastfeeding pts?
Which one should you use caution in giving?
Sertraline, Paroxetine, TCAs
Fluoxetine if other SSRIs ineffective; but caution bc levels are
higher in breast milk than other SSRIs
,Serene Parrots Try, but Flu floats higher
What antiepileptics are Rx of choice for breastfeeding pts?
Carbamazepine, Phenytoin, Valproic Acid
What Antihistamines are Rx of choice for breastfeeding pts?
Which ones should be avoided? Why?
Loratadine + Fexofenadine
1st gen antihistamines assoc. w/ irritability, or sedation + may ↓
milk supply
What Antimicrobials are Rx of choice for breastfeeding pts?
Which ones should be avoided?
Good = Cephalosporins, Aminoglycosides, Macrolides, PCN
Bad = Chloramphenicol + Tetracycline
What Beta-Blockers are Rx of choice for breastfeeding pts?
What other BP Rx are safe?
Labetolol, Metoprolol, Propanolol
*ACE-inhibitors + CCBs also safe*
What Endocrine Rx are okay for breastfeeding pts?
, Propylthiouracil (PTU)
Insulin
Levothyroxine
What Glucocorticoids are Rx of choice for breastfeeding pts?
Prednisone + Prednisolone
What can Retinoids (Isotretinoin, etretinate, large doses of Vit
A) cause during pregnancy?
CNS + Craniofacial + CV Defects
Thymus abnormalities
If a pregnant pt has been exposed to a known teratogen, but after
organogenesis (weeks 3-8), what should you do as a provider?
#1 = Determine timing
(if not taken during organogenesis weeks 3-8, reassure that risk
of malformation minimal)
If a pregnant pt has been exposed to a known teratogen during
organogenesis (weeks 3-8), what should you do as a provider?
#1 = Consult reference on to determine expected malformations
#2 = 2+ ultrasounds to determine extent
Mild anomalies: surgery possible (e.g., cleft palate)
Severe: Consider termination
What factors determine if an Rx enters into breast milk?
Same that determines passage across membrane
