QuestionMultiA
QuestionChoice
33828
d
Lithium carbonate;500mg;oral (PO);12-hourly
QuestionChoice
33827
c
Aspirin;150mg;oral (PO);Daily
QuestionChoice
33831
g
Metformin;500mg;oral (PO);12-hourly
QuestionChoice
33826
b
Tetracycline;500mg;oral (PO);12-hourly
QuestionChoice
33829
e
Levothyroxine;200micrograms;oral (PO);Daily
QuestionChoice
33830
f
Amitriptyline;50mg;oral (PO);Daily
QuestionChoice
33825
a
Fluoxetine;20mg;oral (PO);Daily
QuestionComment
BNF also states that aspirin in high doses can cause 'closure of fetal ductus arteriosus in utero' so I'd say thats a heart defect?
6915
QuestionComment
adding to that, there are conflicting studies as to whether or not SSRIs cause congenital heart defects
40418
User
subscriber
Edema Power
QuestionComment
I thought this, but aspirin can be given up until birth for pre-eclampsia so must be low(ish) risk 
61853
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Rhinoplasty Chronic
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Giggy G
QuestionComment
BNF states that Tetracyclines should not be given in pregnancy! So there should be THREE options for part (A).
39726
QuestionComment
The question wants medications that causes congenital heart defects not contraindications for pregnancy. Tetracyclines affect skeletal development and discolour teeth. Its on the BNF under pregnancy for tetracycline
39995
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Acute DNA
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Palatopterygoquadrate
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2717
Medications during pregnancy
Topic
76
Obstetrics and Gynaecology
1. The use of SSRI such as fluoxetine is known to cause congenital heart diseases especially when taken during early pregnancy. Lithium, a medication used for bipolar disorder, is associated with increased risk of Ebstein’s anomaly when taken in the first trimester.
2. Despite evidence showing that calcium in breast milk prevents the absorption of tetracycline, it is currently still avoided in breastfeeding women. Aspirin increases the risk of Reye’s syndrome. Fluoxetine and lithium carbonate is present in milk and can carry a risk of toxicity in infant.
6784
a d
a b c d
Case presentation: A 40-week pregnant woman is admitted electively for induction of labour. PH Type 2 diabetes mellitus, Depression, Bipolar disorder, Hypothyroid, Tension headache, Acne rosacea. DH Her current regular medications are listed (below).


Question 1: Select the TWO prescriptions that are most likely to be contributing to congenital heart defects (mark them with a tick in column A)
Question 2: Select the FOUR prescriptions that are contraindicated in breastfeeding (mark it with a tick in column B).