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ADSF 101 - WRITTEN ASSIGNMENT DUE DATE: 18.03 2025 TOPIC: PHARMACOLOOY Read the scenario below and anvwer the quesbons that follows; A 32 -year-old Ms. P, at 10 weoks gestation has a hisfory of epllepsy, ype 2 diabedy mellitus, and chronic hypertension bhe has been on phenyioin, metformin, and enalaprll before pregnangy During her fimt antenatal visit, the midwife identifes polential rieks assoclated with t current medications. 1 NTYODUCIION 1 Describe teratogenic risks. 2. Analyse the feratogenic risks of these medications on the developing fetus 3. Evaluate safer pharmacological ehematives that can be prescribed lo mana her conditions. 4. Justify your recommendations using Gvidence-based pharmacotherapy principles, incorporating considerations of pharmacokineties, foetal safes and relevant clinical guidelines 5. CONCLUSSION

Ask by Craig Wood. in South Africa
Mar 16,2025

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**Recommendations for Safer Medications During Pregnancy** 1. **Epilepsy (Phenytoin):** - **Alternative:** Lamotrigine - **Reason:** Lamotrigine has a lower risk of causing congenital malformations compared to phenytoin. 2. **Type 2 Diabetes Mellitus (Metformin):** - **Alternative:** Insulin - **Reason:** Insulin is the standard and safest treatment for managing diabetes during pregnancy. 3. **Chronic Hypertension (Enalapril):** - **Alternatives:** Labetalol or Methyldopa - **Reason:** These medications are safer for the developing fetus compared to enalapril. **Justification:** - **Pharmacokinetics:** The alternatives have lower placental transfer or are well-understood in pregnancy. - **Fetal Safety:** They minimize risks associated with teratogenicity and other developmental issues. - **Guidelines:** Recommendations align with current clinical guidelines to ensure both maternal and fetal safety. **Conclusion:** Switching to lamotrigine for epilepsy, insulin for diabetes, and labetalol or methyldopa for hypertension during pregnancy is recommended to enhance fetal safety and adhere to evidence-based practices.

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Teratogenic risks refer to the potential adverse effects that certain drugs or substances can have on the developing fetus, particularly during the critical periods of embryonic and fetal development. These risks can lead to structural, functional, or developmental anomalies in the offspring. The degree of risk varies depending on the timing of exposure, the dosage, and the specific drug used, highlighting the importance of careful medication management in pregnant individuals. When evaluating the teratogenic risks associated with phenytoin, metformin, and enalapril, several concerns arise. Phenytoin, commonly used for epilepsy, can cause fetal hydantoin syndrome, characterized by growth deficiencies and facial dysmorphism. Metformin, prescribed for type 2 diabetes, is generally considered safer but still must be monitored for potential metabolic implications. Enalapril, an ACE inhibitor for hypertension, poses risks such as fetal renal dysfunction and oligohydramnios. It’s crucial to weigh these factors against the need for maternal health management in the context of pregnancy.

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