Pregnancy and Lactation: Therapeutic Considerations
Chapter 47. Pregnancy and Lactation: Therapeutic Considerations
When analyzing information on the safety of a drug exposure during pregnancy, which one of these statements is true?
A. It is estimated that approximately 10% of congenital anomalies are caused by a medication exposure.
B. FDA categories should not be used to assess the safety of medication use during pregnancy.
C. Animal studies are of equal value with human data to inform on teratogenic risk of a drug.
D. Before a medication is put on the market, it is mandatory to have human pregnancy safety data.
E. The fetogenesis period is the most at risk period for structural congenital anomalies following a teratogenic exposure.
Which of the following key points is appropriate when considering the use of lamotrigine during breast-feeding?
A. It is contraindicated to use lamotrigine during breast-feeding.
B. Lamotrigine blood concentration of a breast-fed infant can be up to 10% to 50% of simultaneous maternal blood concentration.
C. Several cases of severe rash have been reported in breast-fed infants whose mothers were taking lamotrigine.
D. When mothers who take lamotrigine breast-feed, the drug is usually undetectable in the infants’ serum.
E. There is scarcity of data on lamotrigine during breast-feeding.
A 36-year-old woman wishes to become pregnant with her second child. She has been treated for type 2 diabetes for 3 years. She has a well balanced diet with plenty of vegetable and fruits. Based on this information, which of the following is the most appropriate folic acid recommendation for this patient to prevent congenital anomalies?
A. Folic acid 4 mg orally daily starting at 10 weeks’ gestation and throughout pregnancy.
B. Folic acid 0.4 mg with a multivitamin orally daily starting at least 1 month before pregnancy and throughout the first trimester.
C. Folic acid 4 mg with a multivitamin orally daily starting 3 months before pregnancy and throughout the first trimester.
D. Multivitamin containing 0.4 to 0.8 mg of folic acid orally daily starting 1 month before pregnancy and throughout the first trimester.
E. No folic acid supplement is required since folic acid is provided by her diet.