 Transfer of drugs across the placenta and

breast.
 Influence of pregnancy on drug dose
Adverse effects of drugs in pregnancy

TERATOGENESIS:
The word “Teratogen” refers to a substance
that leads to the birth of a malformed baby.
 COMMONLY USED DRUGS THAT ARE
TERATOGENS
DRUG EFFECT
LITHIUM  CARDIAC ANOMALIES
WARFARIN FACIAL ANOMALIES
PHYSTOIN  CRANIOFACIAL
ANOMALIES
SODIUM NEURAL TUBE DEFECTS
VALDPROATE
CARBAMEZEPINE CRANIOFACIAL
ANOMALIES, NEURAL
TUBE DEFECT.
 DRUG EFFECT
SODIUM NEURAL TUBE DEFECTS
VALPROATE
CARBAMEZEPINE CRANIOFACIAL
ANOMALIES NEURAL
TUBE DEFECTS
RETINOIC ACID CRANIOFACIAL CARDIA
DERIVATIVES AND CNS ANOMALIES
 FOLIC ACID
USED:
 Given to treat megaloblastic anemia caused
by folic acid deficiency. Type of Anemia usually
occurs in infants, adolescents, pregnant and
lactating mothers, elderly and alcoholic.
 Also used a s nutritional supplement.
PHARMACOKINETICS
 Absorbed rapidly in the first third of the
small intestine.
 Metabolized in the liver
 Excess folate is excreted in the urine and small
amounts in feces
Folic acid is secreted in breast milk.

CONTRAINDICATION:
 Methotrexate, Sulfalazine, Hormonal
contraceptives, aspirin, triametrene pentamidine,
and trimethropin reduce the effectiveness of folic
acid.
Counteracts the effects of convulsants, such as
phenytoinm potentially seizures.
 ADVERSE REACTION:
 Erythema
 Itching
 Rash
Anorexia
 Nausea
 Altered Sleep Patterns
 Difficulty Concentrating
 Irritability
 Overactivity
 IRON
USED:

 Oral iron therapy is used to prevent or treat iron

deficiency anemia.

 also used to prevent anemia in children age 6

months to 2 years (because this is the rapid growth
and development)

Pregnant woman may need iron supplements to

replace the iron used by the developing fetus.
KINDS
IRON DEXTRAN

 Given by either I.M. Injection or slow continous

I.V infusion

IRON SUCROSE

 Is indicated for used in hemodialysis patient and

admnistered I.V. infusion.
 CONTRAINDICATION
IRON DEXTRAN

 Antacid (H2 receptor antagonist)

 Coffee, Tea, Egg and Milk
IRON SUCROSE
 Is indicated for used in hemodialysis patient and
admnistered I.V. infusion.

ADVERSE REACTION
 Gastric Irritation and Constipation
 Darken Stool
 Liquid preparation can stain the teeth
 ANTACIDS

USED:

 Are Alkalis that act by reducing the acidity of

stomach acid.

KINDS

 Aluminum Carbonate Gel

 Calcium Carbonate
 Magaldrate
 Magnesium Hydroxide
 Simethicone
 CONTRAINDICATION
 Digoxin
 Phenytoin
 Ketoconazole
Iron Salts
 Isoniazid
 Quinolones
 Tetracycline
Note: If taken within 2 hours of ANTACID can decrease reduce absorption

ADVERSE REACTION
 Diarrhea
Constipation
 Electrolyte Imbalance
 Aluminum Accumulation in serum
 ANTIBIOTICS
USED:
Drugs that interfere or kill bacteria or inhibit the
growth bacteria
ANTIBIOTICS THAT MAY CAUSE
ADVERSE EFFECTS IN PREGNANCY
ANTIBIOTIC RISK
GROUP
 Tetralycline  Discoloration and Dysplasia
( Tetracycline, of fetal bones and teeth,
oxytetracycline, cataracts when used in second
doxycycline) and third trimester
 ANTIBIOTIC RISK
GROUP
 Aminoglycoside Risk of ototoxicity but often
(gentamycin used in serious maternal
netilmmicin) infection where benefit
outweights risk.
 Chlorampehnicol  “Grey Baby Syndrome”
when used in second or third
trimester
 Nitrofurantoin  Haemolysis in fetus at term-
avoid during labour and
delivery but safe at other
times.
 Quinolones  Arthropathy in fetus most of
( Ciprofloxacin the evidence for this obtained
ofloxacin) from animal studies.

ANTIBIOTICS THAT MAY CAUSE

ADVERSE EFFECTS IN PREGNANCY
 Antibiotic Penicillins ( Alternatives if allergenic
benzye penicillins,
phenoxymethypenincillin
s
Ampicillin, Amoxicillin,
Co-amoxyclav
(Augmentin) fludoxacillin
Cephalosporins
(Cephradine, Cephalexin,
Cefuroxime,
Cephotaxime
ERTYTHROMYCIN  Avoid in first trimester
TRIMETHOPRIM

OXYTOCIN
USED:
 Induced labor for complete ,incomplete
abortions
 Treat pre - eclampsia, eclampsia and premature
rupture of the membranes.
 Control bleeding and uterine relaxation after
delivery
 hasten uterine shrinking after delivery.
 Stimulate lactation
OXYTOCIN IS USED TO INDUCE OR
REINFORCE LABOR ONLY WHEN:
 The mothers pelvis is known to be adequate.
 Vaginal delivery is indicated the fetus is mature.
 Fetal position is favorable
 Critical care facilities and an experienced
clinician are immediately available.
 CONTRAINDICATION
 Alcohol
 Chloropropamide
 Barbiturates ( leading to arrythmias)
 Cyclosphosphamide
 Vasopresor (Anaesthetic, ephedrhin,
methoxamine
increase the risk of hypertensive crisis.
Postpartum rupture of cerebral blood vessels.
 ADVERSE REACTION
 Hypersensitivity reaction
 Ringing of the ear
 Anxiety
 Hyponatremia ( low serum sodium levels)
 Proteins in the urine.
 Eclamptic attacks
 Pupil dilatation
 Transient edema
 ADMINISTRATION
 Usually it is not given orally because they are
destroyed in the G.I. tract some of these hormones
can be administered topically, but most require
inejction.
 Metabolizes at receptor site and in the liver and
kidneys.
 Excreted primarily in urine.

ANTIHYPERTENSIVE DRUGS
USED:
 to treat hypertension, a disorder characterized by
elevation in systolic blood pressure, diastolic blood
pressure
KINDS
1. ANGIOTENSIN
 Coverting enzyme (ACE) inihibitors
2. ANGIOTENSIN
 Receptor blockers (ARBS)
3. BETA
 Adrenergic Antagonist
4. CALCIUM CHANNEL BLOCKERS
INDICATION
 Reduction of sodium and water retention
 Blood pressure reduction
 Improve renal function in patients with diabetes
SIDE EFFECTS

 Headache
 Fatigue
 Dry, Non Productive, persistent.
 Cough
 Angioedema
 GI Reactions
 Increased serum potassium concentation.
 Tickling in the troat
 Transient elevations of BUN.
 ANESTHETIC CRUGS
USED
Work primarily by drepressing the CNS.
 Producing loss of conciousness
 Loss of Responsiveness to sensory stimulation (
including pain)
 Muscle relaxation

ADVERSE REACTION:

 Malignant hyperthermia, characterized by

suddent and usually lethal increase in body
temperature.
 Depression of breathing and circulation
Hypothermia
 Confusion
Sedation
Nausea and vomitting
Ataxia: