PSA Prescribing in Special Populations 3

Question 1

A pregnant woman in her first trimester requires antibiotic therapy for a urinary tract infection. Which antibiotic is most appropriate?

Accepted Answer

Cefalexin throughout pregnancy

Answer

Cefalexin, a first-generation cephalosporin, is considered safe throughout pregnancy and is a first-line option for UTI treatment in pregnant women.

Question 2

A breastfeeding mother needs analgesia following a Caesarean section. Which analgesic should be used with the greatest caution?

Accepted Answer

Codeine

Answer

Codeine is converted to morphine by CYP2D6; in ultra-rapid metabolizers, excessive morphine passes into breast milk and can cause neonatal respiratory depression.

Question 3

Which antiepileptic drug carries the highest risk of neural tube defects when taken during the first trimester of pregnancy?

Accepted Answer

Sodium valproate

Answer

Sodium valproate is associated with the highest risk of neural tube defects (approximately 3-4%) and major congenital malformations among antiepileptic drugs.

Question 4

A woman with a mechanical heart valve is planning a pregnancy and is currently on warfarin. What is the most appropriate management for the first trimester?

Accepted Answer

Switch to low molecular weight heparin during the first trimester

Answer

Warfarin is teratogenic during the first trimester; low molecular weight heparin does not cross the placenta and is preferred during this period.

Question 5

Which class of antihypertensive drug is contraindicated throughout pregnancy?

Accepted Answer

ACE inhibitors

Answer

ACE inhibitors are contraindicated in pregnancy due to the risk of fetal renal dysgenesis, oligohydramnios, skull hypoplasia, and neonatal renal failure.

(PSA) Prescribing Safety Assessment Practice Test

(PSA) Prescribing Safety Assessment Practice Test

PSA Prescribing in Special Populations 3